***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background The efficacy of amodiaquine ( AQ ) , sulphadoxine-pyrimethamine ( SP ) and the combination of SP+AQ in the treatment of Cameroonian children with clinical malaria was investigated . The prevalence of molecular markers for resistance to these drugs was studied to set the baseline for surveillance of their evolution with time . Methods Seven hundred and sixty children aged 6 - 59 months with uncomplicated falciparum malaria were studied in three ecologically different regions of Cameroon - Mutengene ( littoral equatorial forest ) , Yaoundé ( forest-savannah mosaic ) and Garoua ( guinea-savannah ) . Study children were r and omized to receive either AQ , SP or the combination AQ+SP . Clinical outcome was classified according to WHO criteria , as either early treatment failure ( ETF ) , late clinical failure ( LCF ) , late parasitological failure ( LPF ) or adequate clinical and parasitological response ( ACPR ) . The occurrence of mutations in pfcrt , pfmdr1 , dhfr and dhps genes was studied by either RFLP or dot blot techniques and the prevalence of these mutations related to parasitological and therapeutic failures . Results After correction for the occurrence of re-infection by PCR , ACPRs on day 28 for AQ , SP and AQ+SP were 71.2 % , 70.1 % and 80.9 % , in Garoua , 79.2 % , 62.5 % , and 81.9 % in Mutengene , and 80.3 % , 67.5 % and 76.2 % in Yaoundé respectively . High levels of Pfcrt 76 T ( 87.11 % ) and Pfmdr1 86Y mutations ( 73.83 % ) were associated with quinoline resistance in the south compared to the north , 31.67 % ( 76 T ) and 22.08 % ( 86Y ) . There was a significant variation ( p < 0.001 ) of the prevalence of the SGK haplotype between Garoua in the north ( 8.33 % ) , Yaoundé ( 36.29 % ) in the savannah-forest mosaic and Mutengene ( 66.41 % ) in the South of Cameroon and a weak relation between SGK haplotype and SP failure . The 540E mutation on the dhps gene was extremely rare ( 0.3 % ) and occurred only in Mutengene while the pfmdr1 1034 K and 1040D mutations were not detected in any of the three sites . Conclusion In this study the prevalence of molecular markers for quinoline and anti-folate resistances showed high levels and differed between the south and north of Cameroon . AQ , SP and AQ+SP treatments were well tolerated but with low levels of efficacy that suggested alternative treatments were needed in Cameroon since 2005 We studied three  antimalarial treatments in Caala and Kuito , Angola , in 2002 and 2003 . We tested chloroquine ( CQ ) , amodiaquine ( AQ ) and sulfadoxine-pyrimethamine ( SP ) in Caala , and AQ , SP and the combinations AQ+artesunate ( AQ+AS ) and SP+artesunate ( SP+AS ) in Kuito . A total of 619 children ( 240 in Caala , 379 in Kuito ) with uncomplicated Plasmodium falciparum malaria were followed-up for 28 days , with PCR genotyping to distinguish recrudescence from reinfection . PCR-corrected failure proportions at day 28 were very high in the CQ group ( 83.5 % , 95 % CI 74.1 - 90.5 ) , high in the SP groups ( Caala : 25.3 % , 95 % CI 16.7 - 35.8 ; Kuito : 38.8 % , 95 % CI 28.4 - 50.0 ) , around 20 % in the AQ groups ( Caala : 17.3 % , 95 % CI 10.0 - 27.2 ; Kuito : 21.6 % , 95 % CI 14.3 - 30.6 ) and very low in the artemisinin-based combination groups ( 1.2 % , 95 % CI 0.0 - 6.4 for each combination AQ+AS and SP+AS ) . These results show that CQ and SP are no longer efficacious in Caala and Kuito and that the moderate efficacy of AQ is likely to be compromised in the short term if used as monotherapy . We recommend the use of AQ with AS , though this combination might not have a long useful therapeutic life because of AQ resistance OBJECTIVE In India , till recently , Chloroquine was used as first-line therapy in areas with Chloroquine sensitive Plasmodium falciparum malaria cases . The National Vector Borne Disease Control Programme ( NVBDCP ) has introduced artemisinin combination therapy ( ACT ) as first-line option to treat all P. falciparum cases in the country . This study was carried out to ascertain the efficacy of Chloroquine and Sulphadoxine-Pyrimethamine , either alone or in combination , before the launch of ACT by NVBDCP . METHODS A total of 300 P. falciparum malaria cases were enrolled r and omly in three study arms , Chloroquine ( CQ ) , Sulphadoxine-Pyrimethamine ( SP ) and Chloroquine plus Sulphadoxine-Pyrimethamine ( CQ + SP ) . All patients were followed up for 28 days as per WHO ( Assessment and Monitoring of Antimalarial Drug Efficacy for the Treatment of Uncomplicated Falciparum Malaria , Geneva , 2003 ) Protocol . Paired blood sample s of treatment failure cases were collected and subjected to MSP 1 , MSP 2 and GLURP genotyping for differentiation between re-infection and recrudescence . The data were analysed by Kaplan-Meier survival curve according to WHO st and ard procedures . RESULTS The overall failure rate including both early treatment failure ( ETF ) and late treatment failure ( LTF ) of CQ , SP and CQ + SP were 61 % , 14 % and 8 % , respectively , in the study area . Of 60 recurrent malaria cases , genotyping was successful in 49 cases , revealing that most of the ( 46/49 ; 94 % ) cases of recurrent malaria were due to recrudescence . CONCLUSION In Jalpaiguri District the overall failure rate of CQ was 61 % and of SP 14 % , which was well above the WHO recommended cut-off threshold level ( 10 % ) for change of drug policy BACKGROUND Sulfadoxine/pyrimethamine fixed-dose combination ( FDC ) tablet is the long-acting portion of the antimalaria product Artecospe ( ® ) , coblister containing artesunate tablets plus sulfadoxine/pyrimethamine FDC tablets . This study was conducted to support the efficacy and tolerability of the sulfadoxine/pyrimethamine FDC tablet in the World Health Organization 's ( WHO ) Prequalification of Medicines Programme , as well as to obtain marketing authorization in China . OBJECTIVE The aim of the present study was to compare the pharmacokinetic profiles between a new generic and the br and ed reference formulation of sulfadoxine/pyrimethamine FDC tablets , and to assess the bioequivalence of the 2 products in healthy Chinese volunteers . METHODS This single-dose , open-label , r and omized , parallel-group study was conducted in healthy Chinese male volunteers who were r and omly assigned ( 1:1 ) to receive a single 1500/75-mg dose ( 3 × 500/25-mg tablets ) of either the test or reference formulation after a 12-hour overnight fast  . Seventeen blood sample s were obtained over a 168-hour interval , and plasma concentrations of sulfadoxine and pyrimethamine were determined by 2 separate vali date d liquid chromatography-isotopic dilution mass spectrometry methods . Pharmacokinetic properties ( C(max ) , AUC(0 - 72 ) , AUC(0 - 168 ) , and T(max ) ) were calculated and analyzed statistically . The 2 formulations were to be considered bioequivalent if 90 % CIs for the log-transformed ratios of C(max ) and AUC(0 - 72 ) were within the predetermined bioequivalence range of 80 % to 125 % , in accordance with the guidelines of WHO and China 's Food and Drug Administration ( FDA ) . Tolerability was evaluated throughout the study by vital signs , physical examinations , clinical laboratory tests , 12-lead ECGs , and subject interviews on adverse events ( AEs ) . RESULTS Forty-six healthy subjects completed the study . The mean values of sulfadoxine C(max ) ( 183.07 and 165.15 mg/L ) , AUC(0 - 72 ) ( 11,036.52 and 10,536.78 mg/L/h ) , and AUC(0 - 168 ) ( 22,247.05 and 21,761.02 mg/L/h ) were not significantly different between the test and reference formulations , respectively . The same was true for pyrimethamine ( 0.55 and 0.58 mg/L , 29.85 and 31.44 mg/L/h , and 56.18 and 59.27 mg/L/h , respectively ) . The 90 % CIs for the log-transformed ratios of C(max ) , AUC(0 - 72 ) , and AUC(0 - 168 ) of both sulfadoxine ( 105.4%-116.6 % , 99.3%-110.6 % , and 96.4%-108.1 % ) and pyrimethamine ( 88.8%-100.9 % , 89.5%-101.0 % , and 88.3%-101.6 % ) were within the acceptance limits for bioequivalence . A total of 7 mild AEs were reported in 7 subjects ( 15.2 % ) . CONCLUSIONS The findings from this single-dose ( 1500/75-mg ) study suggest that the test and reference formulations of sulfadoxine/pyrimethamine FDC 500/25-mg tablet have similar pharmacokinetic profiles both in terms of rate and extent of absorption . The formulations met WHO 's and China 's FDA regulatory criteria for bioequivalence in these healthy Chinese volunteers under fasting conditions . Both formulations were generally well-tolerated Background To up date the National Malaria Control Programme of Mali on the efficacy of chloroquine , amodiaquine and sulphadoxine-pyrimethamine in the treatment of uncomplicated falciparum malaria . Methods During the malaria transmission seasons of 2002 and 2003 , 455 children – between six and 59 months of age , with uncomplicated malaria in Kolle , Mali , were r and omly assigned to one of three treatment arms . In vivo outcomes were assessed using WHO st and ard protocol s.  Genotyping of msp1 , msp2 and CA1 polymorphisms were used to distinguish reinfection from recrudescent parasites ( molecular correction ) . Results Day 28 adequate clinical and parasitological responses ( ACPR ) were 14.1 % , 62.3 % and 88.9 % in 2002 and 18.2 % , 60 % and 85.2 % in 2003 for chloroquine , amodiaquine and sulphadoxine-pyrimethamine , respectively . After molecular correction , ACPRs ( cACPR ) were 63.2 % , 88.5 % and 98.0 % in 2002 and 75.5 % , 85.2 % and 96.6 % in 2003 for CQ , AQ and SP , respectively . Amodiaquine was the most effective on fever . Amodiaquine therapy selected molecular markers for chloroquine resistance , while in the sulphadoxine-pyrimethamine arm the level of dhfr triple mutant and dhfr/dhps quadruple mutant increased from 31.5 % and 3.8 % in 2002 to 42.9 % and 8.9 % in 2003 , respectively . No infection with dhps 540E was found . Conclusion In this study , treatment with sulphadoxine-pyrimethamine emerged as the most efficacious on uncomplicated falciparum malaria followed by amodiaquine . The study demonstrated that sulphadoxine-pyrimethamine and amodiaquine were appropriate partner drugs that could be associated with artemisinin derivatives in an artemisinin-based combination therapy As part of an effort to assess antimalarial drug resistance in Peru , we carried out 14-day in vivo efficacy trials of chloroquine ( CQ ; 25 mg/kg ) and sulfadoxine-pyrimethamine ( SP ; 25 mg/kg of the sulfadoxine component ) for the treatment of uncomplicated Plasmodium falciparum infections at three sites on the northern coast of Peru .  
    Output:
    
These results presented a global view for the current status of antimalarial drug resistance and provided a guidance for choice of antimalarials for efficient treatment and prolonging the life span of the current effective antimalarial drugs