ArticlePLoS clinical trials2006
Randomised trial of chloroquine/sulphadoxine-pyrimethamine in Gambian children with malaria: impact against multidrug-resistant P. falciparum.
Article in PLoS clinical trials, 2006. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 4 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
24 citing papers in PubMed, 4 syntheses or guidelines pooled it, 39 citations in OpenAlex.
- Prevalence of antimalaria drug resistance-conferring mutations associated with sulphadoxine-pyrimethamineine-resistant Plasmodium falciparum in East Africa: a systematic review and meta-analysis.Annals of clinical microbiology and antimicrobials · 2025Pooled it
- Systematic review and meta-analysis of the safety of chloroquine and hydroxychloroquine from randomized controlled trials on malarial and non-malarial conditions.Systematic reviews · 2021Pooled it
- Intermittent preventive antimalarial treatment for children with anaemia.The Cochrane database of systematic reviews · 2015Pooled it
- Patterns of chloroquine use and resistance in sub-Saharan Africa: a systematic review of household survey and molecular data.Malaria journal · 2011Pooled it
- Two strategies for the delivery of IPTc in an area of seasonal malaria transmission in the Gambia: a randomised controlled trial.PLoS medicine · 2011Trial
- Trial
- Prevention of the recurrence of anaemia in Gambian children following discharge from hospital.PloS one · 2010Trial
- Trial
- Article
- Stepwise in vitro screening of MMV pathogen box compounds against Plasmodium falciparum to identify potent antimalarial candidates.International journal for parasitology. Drugs and drug resistance · 2023Article
- Molecular surveillance of anti-malarial drug resistance genes in Plasmodium falciparum isolates in Odisha, India.Malaria journal · 2022Article
- Widespread resistance mutations to sulfadoxine-pyrimethamine in malaria parasites imported to China from Central and Western Africa.International journal for parasitology. Drugs and drug resistance · 2020Article
- Naturally acquired immunity against immatureScience translational medicine · 2019Article
- Monitoring malaria using health facility based surveys: challenges and limitations.BMC public health · 2016Article
- Article
- Review: analysis of parasite and other skewed counts.Tropical medicine & international health : TM & IH · 2012Review
- Drug resistance maps to guide intermittent preventive treatment of malaria in African infants.Parasitology · 2011Review
- Comparison of surveillance methods applied to a situation of low malaria prevalence at rural sites in The Gambia and Guinea Bissau.Malaria journal · 2009Article
- Article
- Novel pfdhps haplotypes among imported cases of Plasmodium falciparum malaria in the United Kingdom.Antimicrobial agents and chemotherapy · 2009Article
Corrections and comments
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Authors and funding
12 authors at 2 institutions in 2 countries.
Funding
Abstract
objectivesIn the Gambia, the combination of chloroquine (CQ) and sulphadoxine-pyrimethamine (SP) has replaced CQ monotherapy for treatment of malaria caused by Plasmodium falciparum. We measured the efficacy of the combination CQ/SP, and the prevalence of parasites carrying alleles associated with resistance to CQ or SP.
designWe conducted a single-blind, randomised, controlled trial to compare the efficacy of CQ/SP to that of SP or CQ alone.
settingThe study took place in the town of Farafenni and surrounding villages in the Gambia.
participantsParticipants were children aged 12 mo to 10 y presenting as outpatients with uncomplicated P. falciparum malaria.
interventions500 children were randomised to receive CQ, SP, or CQ/SP as supervised treatment and actively followed over 28 d. OUTCOME MEASURES: Primary outcome was parasitaemia at any time during follow-up. Secondary outcomes were PCR-confirmed recrudescent infections among treatment failures, and clinical failure requiring rescue medication by day 28. Pretreatment parasite isolates from 161 patients were tested for the presence of resistance-associated genetic markers.
resultsThe prevalence of parasitological failure by day 28 for the CQ group was 60.3%, compared to 17.6% for SP (odds ratio [OR], 0.106; 95% confidence interval [CI], 0.057-0.194; p < 0.001) and 13.9% for CQ/SP (OR versus CQ, 0.140; 95% CI, 0.078-0.250; p < 0.001). There was no difference between the SP and CQ/SP groups (OR, 1.324; 95% CI, 0.705-2.50). The projected prevalence of PCR-corrected treatment failure was 30.2, 6.06, and 3.94% in the CQ, SP, and CQ/SP groups, respectively. The pfdhfr-triple mutant and pfdhps-437G mutation were common, with prevalences of 67.4 and 51.2%, respectively. Pretreatment carriage of pfdhps-437G and of multidrug-resistant parasite genotypes was associated with treatment failure in the SP group, but not in the CQ or CQ/SP groups.
conclusionsThe combination of CQ/SP was an efficacious treatment for uncomplicated malaria in Gambian children in this study, but the frequent occurrence of multidrug-resistant parasites suggests that this observed efficacy is not sustainable.
Identifiers
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.