Hindawi Publishing Corporation Journal of Tropical Medicine Volume 2009, Article ID 781865, 7 pages doi:10.1155/2009/781865 Clinical Study Efficacy of Artesunate + Sulphadoxine-Pyrimethamine (AS + SP) and Amodiaquine + Sulphadoxine-Pyrimethamine (AQ + SP) for Uncomplicated falciparum Malaria in Equatorial Guinea (Central Africa) Pilar Charle, 1 Pedro Berzosa, 2 Miguel Angel Descalzo, 2 Aida de Lucio, 2 Jose Raso, 3 Jacqueline Obono, 3 Magdalena Lwanga, 3 Natividad Nlang, 3 Araceli Nchama, 3 Catalina Mangue, 4 Anastasio Micha, 4 Natividad Nsee, 4 Rosario Mesie, 5 Agust´ ın Benito, 2 and Jes ´ us Roche 2 1 Centre for the Control of Diseases, Reference Laboratory of Malaria, National Centre of Tropical Medicine—ISCIII, Malabo, Equatorial Guinea 2 National Centre of Tropical Medicine, Institute of Health Carlos III, 28029 Madrid, Spain 3 Reference Laboratory of Malaria, MINSABS and ISCIII, Malabo, Equatorial Guinea 4 Reference Laboratory of Malaria, MINSABS and ISCIII, Bata, Equatorial Guinea 5 Paediatric Department, Regional Hospital of Malabo, Malabo, Equatorial Guinea Correspondence should be addressed to Pilar Charle, piluca ch@yahoo.es Received 6 October 2008; Revised 11 February 2009; Accepted 26 March 2009 Recommended by Sukla Biswas Objectives. The objectives of the study were (i) to evaluate the efficacy of combination drugs, such as artesunate + sulphadoxine- pyrimethamine (AS + SP) and amodiaquine + sulphadoxine-pyripethamine (AQ + SP) in treatment of uncomplicated falciparum malaria (ii) to differentiate recrudescence from reinfection by analysing msp-1 and msp-2 genes of Plasmodium falciparum in treatment failure cases. Methods. We carried out an in vivo study in the year 2005 in 206 children between 6 to 59 months age groups. Of the 206, 120 received AQ + SP, and 86 received AS + SP. A clinical and parasitological followup during 14 days was undertaken. Finger-prick blood sample from each patient was taken on Whatman filter paper (no. 3) on days 0, 7, 14 and also the day when the parasite and symptoms reappeared for PCR analysis. Results. Late treatment failure was observed in 3.5% (4/114) with AQ + SP, and 2.5% (2/79) with AS + SP. The success rate was 96.5% with AQ + SP and 97.5% with AS + SP. No deaths and severe reactions were recorded. Out of the 6 treatment failure cases, one was reinfection as observed by PCR analysis of msp-1 and msp-2 genes on day 14. Discussion. Both the combinations found to be efficacious and safe and could be used as a first-line treatment for uncomplicated falciparum malaria in Equatorial Guinea. Copyright © 2009 Pilar Charle et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 1. Background Malaria is the major cause of morbidity and mortality in children under five years in Sub-Saharan Africa [1]. In areas of stable malaria transmission, like Equatorial Guinea, 25–40% of the patients in clinics and 20–50% of hospital admissions are due to malaria. The falciparum malaria is the cause of at least 20% of death in fewer than five years old children [1]. In Sub-Saharan Africa, the mortality in children under five years old during the period between 1990 and 1998 was doubled compared with the period from 1982 to 1989. One of the most important reasons of this increase in the mortality rates is the spread of antimalarial drug resistance in Africa [2]. The prevalence of malaria infection in children less than five years is 22% and 48% in Malabo (Island Region) and in Bata (Continental Region). The more frequent species