Artesunate-amodiaquine treatment for children with uncomplicated malaria in Kalimantan and Sulawesi: clinical complaints, tolerability and compliance
Abstract
Background Artesunate-amodiaquine combination (AS+ AQ)is one type of artemisinin-based combination therapy (ACT) and
has been used in Indonesia since 2004 for uncomplicated malaria,
both in adults and children. However, its use in the Indonesia
Malaria Program has not yet been evaluated.
Objective To evaluate the clinical complaints and tolerability
to AS+AQ treatment, as well as compliance in children with
uncomplicated malaria.
Methods This was a cross-sectional study, conducted in sentinel
puskesmas (primary health centers) in Kalimantan and Sulawesi.
Subjects were 126 children aged under 15 years, with P. falciparum,
P. vivax, or mixed falciparum-vivax malaria infections. All subjects
were treated with a single dose of AS+AQ for three consecutive
days and followed-up 3 times (D3, D7 and D28) to record clinical
complaints and tolerability after drug administration. Parents/
guardians underwent in-depth interviews on the knowledge,
attitudes and practices of the ACT used as well as clinical
complaints following AS+ AQ treatment.
Results Of the 126 subjects evaluated, 30 were infected with P.
falciparum, 5 9 with P. vivax, and 3 7 with both species. About 84% of
the subjects reported clinical complaints after AS+ AQ administration
(DO-DZ), most commonly lethargy, nausea and vomiting, similar to
the clinical symptoms of malaria. All complaints were reported to be
mild and tolerable. Only one subject was lost to follow-up.
Conclusion Clinical complaints experienced by malaria-infected
children following AS+AQ treatment were relatively tolerable.
Subjects' compliance to AS+ AQ treatment was satisfactory.
[Paediatr lndones. 2012;52:10-5).
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Accepted 2016-08-21
Published 2012-03-30