Effect of Antimalarial Treatment on Gametocyte Carriage in Asymptomatic P. Falciparum
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Treatment of uncomplicated P.falciparum malaria with sulfadoxine-pyrimethamine (SP) is followed by a marked increase in the density of gametocytes. To determine whether treatment with SP enhances gametocyte carriage, we randomized asymptomatic carriers of P.falciparum to receive SP alone, SP with a single dose of artesunate, or placebo, and followed them for 56 days to record gametocyte presence and density.
Condition or disease
Asymptomatic P.Falciparum Malaria
Drug: Sulfadoxine-pyrimethamineDrug: Sulfadoxine-pyrimethamine plus artesunate
Treatment of P. falciparum malaria with sulfadoxine-pyrimethamine (SP) is followed by a sharp rise in the density of gametocytes. Drug-induced release could enhance transmission of resistant parasites and would argue against the use of SP, especially for intermittent preventive treatment (IPT). We did a randomized trial to determine the effect of treatment with SP on gametocyte carriage. The trial is a three-arm open-label randomized trial. We randomized asymptomatic carriers of P.falciparum to receive antimalarial treatment or placebo, and recorded the prevalence and density of gametocytes over the next 2 months. The trial was conducted during the dry (low malaria transmission) season in four rural villages in The Gambia. Adults and children aged over 6 months who had asexual P.falciparum infection and were confirmed to be free of clinical symptoms of malaria over a 2-day screening period were enrolled and randomized to receive a single dose of SP, or SP plus a single dose of artesunate (SP+AS), or placebo. The primary endpoints were presence of gametocytes 7 and 56 days after treatment, and the duration and density of gametocytaemia over 2 months measured by the area under the curve of gametocyte density against time.
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Ages Eligible for Study:
6 Months and older (Child, Adult, Senior)
Sexes Eligible for Study:
Accepts Healthy Volunteers:
P.falciparum parasitaemia above 20/uL
Resident in one of the four study villages
Any other sign of clinical malaria
History of hypersensitivity to any of the study drugs
Treatment with any of the study drugs in the last 4 weeks