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Adding 3 dose artesunate to pyrimethamine sulfadoxine reduced treatment failure in children with acute uncomplicated malaria

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 QUESTION: In Gambian children with acute uncomplicated malaria, is pyrimethamine sulfadoxine (PS) and artesunate more effective than PS alone for Plasmodium falciparum malaria?


Randomised (allocation concealed*), blinded (patients, parents, and investigators),* placebo controlled trial with 28 day follow up.


5 health centres in the Gambia (1 in a semiurban coastal area and 4 in the rural inland region).


600 children who were <10 years of age (mean age 5 y, 52% boys), weighed >5 kg, were infected with P. falciparum at a density of ≥500/μl, had a history of fever, and lived within 20 km of a trial centre. Exclusion criteria were requirement for parenteral treatment, treatment within the previous 2 weeks with PS, a haematocrit concentration …

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  • Source of funding: UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR).

  • For correspondence: Dr L von Seidlein, International Vaccine Institute, Seoul National University Campus, Shillim-Dong, Kwahak-gu, Seoul 151742, Korea.

  • * See glossary.

  • p Value calculated from data in article.