Proguanil/sulfamethoxazole malaria chemoprophy-laxis on the Thai-Cambodian border.
383 Thai soldiers on the Thai-Cambodian border were entered into a randomized malaria chemoprophylactic trial. Proguanil (200 mg/day) combined with sulfamethoxazole (1000 or 1500 mg/day) were compared to a standard combination of weekly pyrimethamine/dapsone (Maloprim). Men receiving proguanil/sulfamethoxazole had a significantly lower malaria attack rate than those taking pyrimethamine/dapsone. This was true of both the first five-week phase in which 1000 mg of sulfamethoxazole was used (0.11 vs 0.26; p less than 0.001) and in the second ten weeks in which 1500 mg of sulfamethoxazole was used (0.13 vs 0.30; p less than 0.001). Combined relative efficacy indicated that proguanil/sulfamethoxazole was better than pyrimethamine/dapsone by 64% for Plasmodium vivax and by 38% for P. falciparum. Unenforced compliance as measured by returned pills was greater than 86% in both groups. No serious drug side-effects were observed. Proguanil/sulfamethoxazole may represent a useful chemoprophylactic option in areas of multiple drug-resistant malaria.
Karwacki
J J
JJ
Department of Medicine, Armed Forces Research Institute Medical Sciences, Bangkok, Thailand.
Shanks
G D
GD
Suriyamongkol
V
V
Watanasook
C
C
D000328:Adult; D000818:Animals; D002160:Cambodia; D003622:Dapsone / Q000009:adverse effects / Q000627:therapeutic use; D004351:Drug Resistance; D004359:Drug Therapy, Combination; D006801:Humans; D008288:Malaria / Q000517:prevention & control*; D008297:Male; D008889:Military Personnel; D010349:Patient Compliance; D010963:Plasmodium falciparum; D002727:Proguanil / Q000009:adverse effects / Q000627:therapeutic use*; D011739:Pyrimethamine / Q000009:adverse effects / Q000627:therapeutic use; D013420:Sulfamethoxazole / Q000009:adverse effects / Q000627:therapeutic use*; D013785:Thailand
D003622:Dapsone; D013420:Sulfamethoxazole; D002727:Proguanil; D011739:Pyrimethamine