Efficacy of monotherapies and artesunate-based combination therapies in children with uncomplicated malaria in Somalia

Acta Trop. 2009 Feb;109(2):146-51. doi: 10.1016/j.actatropica.2008.10.009. Epub 2008 Nov 5.


In order to guide the antimalarial treatment policy of Somalia, we conducted therapeutic efficacy studies of routinely used antimalarial monotherapies as well as artemisinin-based combination therapies (ACTs) for uncomplicated malaria in three sentinel sites during 2003-2006. Therapeutic efficacy of chloroquine (CQ), amodiaquine (AQ) and sulfadoxine/pyrimetahmine (SP) monotherapies, and artesunate plus SP (AS+SP) or AQ (AS+AQ) were evaluated in children 6 months to 10 years old with uncomplicated malaria. For the assessment of the monotherapies, 2003 WHO protocol with 14-day follow-up was used while the 2005 WHO protocol with 28-day follow-up was used for testing the ACTs. Of the monotherapies, CQ performed very poorly with treatment failures varying from 76.5% to 88% between the sites. AQ treatment failure was low except for Janale site with treatment failure of 23.4% compared to 2.8% and 8% in Jamame and Jowhar, respectively. For SP, treatment failures from 7.8% to 12.2% were observed. A 28-day test of artemisinin-based combinations, AS+SP and AS+AQ, proved to be highly efficacious with cure rates of 98-100% supporting the choice of AS+SP combination as first line treatment for uncomplicated malaria for Somalia.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Amodiaquine / therapeutic use*
  • Antimalarials / therapeutic use*
  • Artemisinins / therapeutic use*
  • Artesunate
  • Child
  • Child, Preschool
  • Chloroquine / therapeutic use*
  • Drug Combinations
  • Drug Therapy, Combination
  • Female
  • Humans
  • Infant
  • Malaria / drug therapy*
  • Male
  • Pyrimethamine / therapeutic use*
  • Somalia
  • Sulfadoxine / therapeutic use*
  • Treatment Outcome


  • Antimalarials
  • Artemisinins
  • Drug Combinations
  • Amodiaquine
  • fanasil, pyrimethamine drug combination
  • Artesunate
  • Sulfadoxine
  • Chloroquine
  • Pyrimethamine