title: Parasitological, clinical and haematological response of children with Plasmodium falciparum to 4-aminoquinolines and to pyrimethamine-sulfadoxine with quinine in western Kenya.
abstract: Children with Plasmodium falciparum infections in Western Province, Kenya, were studied in 1987 for their parasitological, clinical and haematological response to chloroquine, to amodiaquine and to pyrimethamine-sulfadoxine plus quinine. Ninety-eight children under 5 years of age were treated in 1 of 2 hospitals. Of the 56 patients treated with chloroquine base 25 mg/kg, 91% had resistant infections, with 36% having no significant decrease in parasitaemia (RIII resistance); however, 69% responded clinically within a week. Of the 27 patients treated with amodiaquine base 25 mg/kg, 67% had resistant infections, with 7% RIII resistant; 81% responded clinically. The parasites cleared in all 15 children given pyrimethamine-sulfadoxine plus 3 days of quinine. Only when parasites cleared did patients have improved haemoglobins and haematocrits. This study shows that parasitaemia in children hospitalized in western Kenya responds poorly to 4-aminoquinolines, although the patients improve clinically, at least during the first 7 days. Young children may need to clear parasites to avoid the risk of severe anemia and the need for blood transfusions.
authors.affiliation: St. Mary's Hospital, Mumias, Kenya.
authors.forename: M
authors.initials: M
authors.lastname: Keuter
authors.forename: J
authors.initials: J
authors.lastname: Sanders
authors.forename: M
authors.initials: M
authors.lastname: Ronday
authors.forename: S
authors.initials: S
authors.lastname: Veltkamp
authors.forename: H
authors.initials: H
authors.lastname: Kamsteeg
authors.forename: E
authors.initials: E
authors.lastname: Schouten
authors.forename: G
authors.initials: G
authors.lastname: Khalumi
authors.forename: W
authors.initials: W
authors.lastname: Ngwawe
authors.forename: J C
authors.initials: JC
authors.lastname: Wetsteyn
authors.forename: A D
authors.initials: AD
authors.lastname: Brandling-Bennett
mesh_terms: D000655:Amodiaquine / Q000008:administration & dosage / Q000627:therapeutic use; D000962:Antimalarials / Q000008:administration & dosage / Q000627:therapeutic use*; D002738:Chloroquine / Q000008:administration & dosage / Q000627:therapeutic use; D004338:Drug Combinations; D004351:Drug Resistance; D004359:Drug Therapy, Combination; D004906:Erythrocyte Count; D005260:Female; D006400:Hematocrit; D006454:Hemoglobins / Q000032:analysis; D006761:Hospitals; D006801:Humans; D007223:Infant; D007630:Kenya / Q000453:epidemiology; D016778:Malaria, Falciparum / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology; D008297:Male; D011739:Pyrimethamine / Q000008:administration & dosage / Q000627:therapeutic use; D011803:Quinine / Q000008:administration & dosage / Q000627:therapeutic use; D012156:Reticulocytes / Q000737:chemistry; D016036:Seroepidemiologic Studies; D013413:Sulfadoxine / Q000008:administration & dosage / Q000627:therapeutic use
chemical_list: D000962:Antimalarials; D004338:Drug Combinations; D006454:Hemoglobins; D000655:Amodiaquine; D013413:Sulfadoxine; D002738:Chloroquine; D011803:Quinine; D011739:Pyrimethamine