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Les raisons d’un changement de médicaments de première intention pour le traitement du paludisme simple au Burkina Faso en 2005.
Change of antimalarial first-line treatments in Burkina Faso in 2005.
A. Gansané, I. Nébié, I. Soulama, A. Tiono, A. Diarra, A.T. Konaté, A. Ouédraogo & B.S. Sirima

Le Burkina Faso a récemment changé de politique de traitement du paludisme simple avec l’association artéméther/luméfantrine ou artésunate/amodiaquine comme médicament de première intention et la sulfadoxine/pyriméthamine pour le traitement présomptif intermittent chez la femme enceinte en lieu et place de la chloroquine dans les deux cas. Avant cette prise de décision, nous avons conduit une étude d’efficacité thérapeutique avec la chloroquine et la sulfadoxine/pyriméthamine dans le traitement du paludisme simple à Plasmodium falciparum en milieu urbain au Burkina Faso de septembre à décembre 2003. La chloroquine (25 mg/kg sur 3 jours) ou la sulfadoxine/pyriméthamine (25 mg/kg + 0,025 mg/kg dose unique) a été administrée respectivement à 137 et 125 enfants âgés de 6 à 59 mois dans une étude randomisée et ouverte. Un suivi de 28 jours selon le protocole modifié de l’OMS a été effectué. Après correction des résultats par PCR, les taux d’échecs thérapeutiques étaient respectivement de 63,4 % (83/131) et 13,8 % (17/123) pour la chloroquine et la sulfadoxine/pyriméthamine. Ces résultats compilés à d’autres observations ont justifié le changement de la politique de traitement du paludisme au Burkina Faso en 2005.

paludisme – Plasmodium falciparum – résistance – chloroquine – sulfadoxine-pyriméthamine – efficacité – enfant – milieu urbain – Ouagadougou – Burkina Faso – Afrique intertropicale

Burkina Faso has recently changed the antimalarial drug policy to artesunate/amodiaquine or artemether/lumefantrine as the first-line antimalarial drug and sulfadoxine/pyrimethamine for the intermittent preventive treatment in pregnant woman. Before the implementation of this new strategy, we conducted an in vivo efficacy study with chloroquine or sulfadoxine/pyrimethamine for treatment of uncomplicated Plasmodium falciparum malaria in urban area of Burkina from September to December 2003. Chloroquine (25 mg/kg over 3 days) or sulfadoxine/pyrimethamine (25 mg/kg + 0.025 mg/kg single dose) was administered respectively to 137 and 125 children aged from 6 to 59 months old in a randomized, opened study. Follow up extended over 28 days using modified WHO protocol. After adjusting the results by PCR, treatment failures rates were 63.4% (83/131) and 13.8% (17/123) respectively for chloroquine and sulfadoxine/pyriméthamine. These results with other observations have justified the change of malaria therapy policy in Burkina Faso in 2005.

malaria – Plasmodium falciparum – resistance – chloroquine – sulfadoxine/pyrimethamine – efficacy – child – urban area – Ouagadougou – Burkina Faso – Sub Saharan Africa

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