Haematological safety of long-term malarial prophylaxis with dapsone-pyrimethamine.
There are no published haematological data on the long-term (more than one year) use of dapsone-pyrimethamine (Maloprim, Folaprim; one tablet a week) for malarial prophylaxis. In a study of 373 male Papua New Guinean soldiers who had used this combination for five years, we found no haematological abnormalities attributable to dapsone-pyrimethamine. Furthermore, the haematological parameters of these soldiers were not clinically different from those of Papua New Guinean university students who did not ingest antimalarial drugs prophylactically. In a parallel study, 9 of 159 white persons (6 children and 3 adult females) who had used dapsone-pyrimethamine prophylaxis for more than one year had haematological abnormalities attributable to the drug. Additionally, the mean leucocyte count of children aged 1-9 years who took dapsone-pyrimethamine was markedly lower--although within the normal range--than that of similarly aged children who received chloroquine for malarial prophylaxis. The appreciable incidence of haematological abnormalities observed in children during malarial prophylaxis with dapsone-pyrimethamine demonstrates the need to select a dose for this group on a weight rather than an age basis and to use a liquid formulation to facilitate the administration of the appropriate dose of this combination. Haematological monitoring of the long-term use of dapsone-pyrimethamine is recommended and a suitable monitoring regimen is suggested.
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000962:Antimalarials / Q000008:administration & dosage* / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D003622:Dapsone / Q000008:administration & dosage* / Q000009:adverse effects; D004338:Drug Combinations / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D006402:Hematologic Diseases / Q000139:chemically induced*; D006801:Humans; D007223:Infant; D008288:Malaria / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D010219:Papua New Guinea; D011739:Pyrimethamine / Q000008:administration & dosage* / Q000009:adverse effects; D013997:Time Factors
D000962:Antimalarials; D004338:Drug Combinations; C001678:Maloprim; D003622:Dapsone; D011739:Pyrimethamine