title: Lack of efficacy of pyrimethamine prophylaxis in pregnant Nigerian women.
abstract: To evaluate the efficacy of pyrimethamine on the blood stage (suppressive prophylaxis) and liver stage (causal prophylaxis) of Plasmodium falciparum in pregnant women, in vivo and in vitro field studies were conducted in Ilorin, Nigeria, from Jan 1 to June 30, 1988. For pregnant women with P falciparum infections who received 25 mg of pyrimethamine weekly for suppressive prophylaxis, 67% (59/88) of in vivo and 60% (6/10) of in vitro tests showed pyrimethamine resistance. A second group of parasitaemic and parasite-free pregnant women was enrolled to evaluate the efficacy of pyrimethamine as a primary tissue schizonticide; after receiving a curative dose of chloroquine (25 mg/kg), half the women were given 25 mg of pyrimethamine weekly and half received no prophylaxis. Parasitologic failure rates did not differ between the pyrimethamine-treated (8/34) and the control (11/37) groups during the 16-week follow-up. Thus, pyrimethamine is not effective for suppressive or causal prophylaxis in pregnant women in Ilorin.
authors.affiliation: Division of Parasitic Diseases, Centers for Disease Control, Atlanta, Georgia 30333.
authors.forename: B L
authors.initials: BL
authors.lastname: Nahlen
authors.forename: A
authors.initials: A
authors.lastname: Akintunde
authors.forename: T
authors.initials: T
authors.lastname: Alakija
authors.forename: P
authors.initials: P
authors.lastname: Nguyen-Dinh
authors.forename: O
authors.initials: O
authors.lastname: Ogunbode
authors.forename: L D
authors.initials: LD
authors.lastname: Edungbola
authors.forename: O
authors.initials: O
authors.lastname: Adetoro
authors.forename: J G
authors.initials: JG
authors.lastname: Breman
mesh_terms: D000293:Adolescent; D000328:Adult; D000818:Animals; D002738:Chloroquine / Q000627:therapeutic use; D004341:Drug Evaluation; D004351:Drug Resistance; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D008288:Malaria / Q000517:prevention & control* / Q000652:urine; D009549:Nigeria; D010298:Parity; D010963:Plasmodium falciparum / Q000187:drug effects / Q000302:isolation & purification; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000517:prevention & control* / Q000652:urine; D011739:Pyrimethamine / Q000008:administration & dosage / Q000627:therapeutic use* / Q000652:urine; D016032:Randomized Controlled Trials as Topic; D013607:Tablets
chemical_list: D013607:Tablets; D002738:Chloroquine; D011739:Pyrimethamine