Authors : C. Obua , M. Ntale , J.W. Ogwal-Okeng , L.L. Gustafsson , U. Hellgren and M.G. Petzold
Abstract: The importance of nutritional status on the given dose, drug concentrations and treatment outcome were explored during treatment with fixed-dose chloroquine plus sulfadoxine/pyrimethamine (CQ+SP) in uncomplicated falciparum malaria. A total of 83 children were treated. Younger children (6-24 months) were given half-strength (HS) and older children (2-5 years) full-strength (FS) CQ+SP as recommended. The concentrations of CQ and sulfadoxine (S) were determined by HPLC in 100 �L of capillary blood on filter paper. Multiple logistic regressions were used to determine associations with outcomes. Stunting (height-for-age <-2 Z-scores) was more common (27.7%) compared to underweight (wt-for-age <-2 Z-scores, 19.3%) and wasting (wt-for-ht <-2 Z-scores, 9.6%). Between the dose groups stunting was significantly common among the younger children than the older children (51.6% vs. 13.5%, respectively, p = 0.005), with mean given doses of CQ and S (mg kg 1) lower in the HS than FS dose groups (p<0.001). Day 1 concentrations of S were also higher in the FS compared to the HS dose group. Nearly all children with day 1 S and day 3 CQ concentrations above the population mean cured. Significant explanatory covariates for cure were day 1 S concentration (p = 0.004), day 3 CQ concentration (p = 0.037) and stunting (p = 0.046). During the fixed-dose CQ+SP combination older children got higher than the recommended doses which resulted in higher blood concentrations of CQ and S with significantly better cure rates. Stunting resulted in higher given doses which may have contributed to better cure rates.
C. Obua , M. Ntale , J.W. Ogwal-Okeng , L.L. Gustafsson , U. Hellgren and M.G. Petzold , 2008. Impact of Nutritional Status on Fixed-dose Chloroquine and Sulfadoxine/Pyrimethamine Combination Treatment of Malaria in Ugandan Children. International Journal of Tropical Medicine, 3: 53-59.