Efficacy of a 3-day oral regimen of quinine in an area of northern Nigeria with low-grade resistance of Plasmodium falciparum to chloroquine and sulphadoxine-pyrimethamine.
The efficacy in vivo of a 3-day oral regimen of quinine (30 mg/kg/day) was assessed in 34 children with falciparum malaria in an area of northern Nigeria with previously documented low-grade parasite resistance to chloroquine and sulphadoxine-pyrimethamine (SDX/PYR). By day 4, all 34 children were free of parasites. Mean parasite clearance time and fever clearance time were 2.7 and 1.7 days, respectively. However, on day 14, 5 (14.7%) children were again parasitaemic and 4 of them were clinically ill. They were again treated successfully with a standard course of oral chloroquine. No adverse drug effects were recorded. Of the 34 children, 9 parasite isolates were successfully cultured in vitro. EC50 and EC99 were 14.0 and 126.0 pmol per well respectively, indicating decreased parasite sensitivity but no resistance in vitro. In conclusion, the 3-day course of quinine was found to be an effective alternative to standard chloroquine treatment in the study area.
Adagu
S I
SI
Department of Pharmacology, Ahmadu Bello University, Zaria, Nigeria.
Okoyeh
J N
JN
Lege-Oguntoye
L
L
Ogala
W N
WN
Ogunrinde
G O
GO
Faji
J T
JT
Sani
A H
AH
D000284:Administration, Oral; D000818:Animals; D000962:Antimalarials / Q000008:administration & dosage* / Q000494:pharmacology / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D002738:Chloroquine / Q000494:pharmacology; D004334:Drug Administration Schedule; D004338:Drug Combinations; D018432:Drug Resistance, Multiple; D006801:Humans; D007223:Infant; D016778:Malaria, Falciparum / Q000188:drug therapy* / Q000469:parasitology; D009549:Nigeria; D010963:Plasmodium falciparum / Q000187:drug effects*; D011739:Pyrimethamine / Q000494:pharmacology; D011803:Quinine / Q000008:administration & dosage* / Q000494:pharmacology / Q000627:therapeutic use; D013413:Sulfadoxine / Q000494:pharmacology
D000962:Antimalarials; D004338:Drug Combinations; C001205:fanasil, pyrimethamine drug combination; D013413:Sulfadoxine; D002738:Chloroquine; D011803:Quinine; D011739:Pyrimethamine