Randomized Trial of Artesunate+Amodiaquine, Sulfadoxine-Pyrimethamine+Amodiaquine, Chlorproguanal-Dapsone and SP for Malaria in Pregnancy in Tanzania 英文参考文献.docVIP

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Randomized Trial of Artesunate+Amodiaquine, Sulfadoxine-Pyrimethamine+Amodiaquine, Chlorproguanal-Dapsone and SP for Malaria in Pregnancy in Tanzania 英文参考文献.doc

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RandomizedTrialofArtesunateAmodiaquine,Sulfadoxine-PyrimethamineAmodiaquine,Chlorproguanal-DapsoneandSPforMalariainPregnancyinTanzania英文参考文献

RandomizedTrialofArtesunate+Amodiaquine, Sulfadoxine-Pyrimethamine+Amodiaquine, Chlorproguanal-DapsoneandSPforMalariain PregnancyinTanzania TheonestK.Mutabingwa1,2*,KandiMuze3,4,RosalynnOrd1,MarnieBricen?o5,BrianM.Greenwood1, ChrisDrakeley1,ChristopherJ.M.Whitty1 1DepartmentofInfectiousandTropicalDiseases,LondonSchoolofHygieneTropicalMedicine,London,UnitedKingdom,2NationalInstituteforMedicalResearch,Dar- es-Salaam, Tanzania, 3Muheza Designated District Hospital, Muheza, Tanga Region, Tanzania, 4Muhimbile Medical Centre, Dar-es-Salaam,Tanzania, 5Department of GenomeSciences,UniversityofWashington,Seattle,Washington,UnitedStatesofAmerica Abstract Background: Malaria in pregnancy is serious, and drug resistance in Africa is spreading. Drugs have greater risks in pregnancy and determining the safety and efficacy of drugs in pregnancy is therefore a priority. This study set out to determinetheefficacyandsafetyofseveralantimalarialdrugsandcombinationsinpregnantwomenwithuncomplicated malaria. Methods: Pregnant women with non-severe, slide proven, falciparum malaria were randomised to one of 4 regimes: sulfadoxine-pyrimethamine [SP]; chlorproguanil-dapsone [CD]; SP+amodiaquine [SP+AQ] or amodiaquine+artesunate [AQ+AS].Randomisationwasona1:2:2:2ratio.Womenwereadmittedfortreatment,andfollowedatdays7,14,21,28after the start of treatment, at delivery and 6 weeks after delivery to determine adverse events, clinical and parasitological outcomes.Primaryoutcomewasparasitologicalfailurebyday28. Results:1433pregnantwomenwerescreened,ofwhom272metentrycriteriaandwererandomised;28toSP,81toCD,80 toSP+AQand83toAQ+AS.Follow-uptoday28posttreatmentwas251/272(92%),andto6weeksfollowingdelivery91%. Byday28parasitologicalfailurerateswere4/26(15%,95%CI4–35)intheSP,18/77(23%,95%CI14–34)intheCD,1/73(1% 95%CI 7–0.001) in the SP+AQ and 7/75 (9% 95%CI 4–18) in the AQ+AS arms respectively. After correction by molecular markersforreinfectiontheparasitologicalfailureratesatday28were18%forCD,1%forSP+AQa