Hi, I'm running a consultancy on CMAM, in the national protocol they suggest too follow the malaria national protocol, wich is right. But the malaria national protocole use amodiaquine. And we know that "some of the drugs used in treating malaria are potentially more toxic in the malnourished child than in well-nourished children and should be avoided if possible. Combinations containing amodiaquine should be avoided in the severely malnourished until their safety is confirmed in this group of children"... I would like too know if some any medical article refer to that. I would like to use it in reference. I supposes that no any survey being done on that, but i'm sure something been wrote about that, but I could'nt find it. Thank you C
Chantal, I will have a better look tomorrow whenI have more time but have you looked at the draft of the new WHO guidelines... It is full of references and might help you with this... Will send it to you tomorrow if you don't have it... A.
Alexandra Rutishauser-Perera

Answered:

11 years ago
Hi Alex, Where did you find it? I spent an evening searching it, I find a lot of reference but only in the national protocols of many countries, and I need more solid than that. So yes thank you if you can send it to me. C.
chantal a

Answered:

11 years ago
Hi Chantal Try this links , hope they will be helpful. http://www.omicsonline.org/2161-0681/2161-0681-S3-005.pdf http://www.malariajournal.com/content/8/1/192 Rogers
Rogers Wanyama

Answered:

11 years ago
Chantal, I sent it in your mail but I didn't find interesting on malaria in it... You might want to check the WHO library as well: [url]http://www.who.int/elena/en/[/url] A.
Alexandra Rutishauser-Perera

Answered:

11 years ago
Dear Chantal We have recently written a review of management of infections in SAM, including malaria, on the CMAM forum: http://www.cmamforum.org/ (you have to log in to see it, but it's free). Apart from the DRC study that Rogers Wanyama gave a link to, there are no studies of either the safety or efficacy of amodiaquine in SAM. That study suggested amodiaquine is effective in SAM, but the number was too small to assess safety. It is unlikely that any such studies will be done and unfortunately, people don't usually report on outcomes in routine programmes. It is likely that you will have to follow national policy. However, if there were a decision being made then currently, the safest and most effective drug for uncomplicated malaria in children is artemether-lumefantrine. Best wishes Jay
Jay Berkley
Technical Expert

Answered:

11 years ago
Hello, Thank you all. I know the CMAM Forum and I had seen the study. I read it again with Roger sending. I was hoped to find something else. As mentioned in the article I do not I either found evidence indicating that it may have a potential hazard for children. But as we found this recommendation in almost all african national protocols west I tell myself that there must be some reference somewhere. So I will not take this recommendation in my report with no scientific proof. By cons is that you'll have an article showing that is "better" for malnourished children being treated with artemether-lumefantrine? thank you very much to all. C.
chantal a

Answered:

11 years ago
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