Objective: Transmission of malaria in the Central African Republic is holoendemic. The disease accounts for 40% of medical consultations and is the leading cause of morbidity and mortality. Central African Republic is classified by WHO in zone C for resistance to traditional anti-malaria drugs such as chloroquine, sulfadoxine-pyrimethamine, and amodiaquine. In this setting, our study sought to evaluate the therapeutic effectiveness and the feasibility (acceptability) of artemether in the treatment of uncomplicated malaria in young children in Bangui.
Methods: This non-comparative, cross-sectional, open study included children aged from 6 months to 5 years of age treated for uncomplicated malaria at the Urban Health Center (CSU) of Bédé-Combatant from May through November 2005. All children had a specific Plasmodium falciparum infection and both parasitemia ranging from 2,000 to 100,000 parasites/microL in uncomplicated malaria and an axillary temperature of 37.5 degrees C or higher but lower than 39.5 degrees C. Epi info software, version 6.03, was used for the data analysis.
Results: The study included 53 children, only 49 of whom could be analysed. An adequate clinical and parasitological response (ACPR) was obtained for 47 (96%), early therapeutic failure was detected for 1 patient (on D2), and late parasitological failure on D14 for another. On the whole, only 4% could be qualified as early or late treatment failure. Tolerance was excellent.
Conclusion: Artemether was well tolerated. This agent is an effective and safe alternative for the treatment of uncomplicated P. falciparum malaria in children in the Central African Republic.