Response of falciparum malaria to chloroquine and three second line antimalarial drugs in a Kenyan coastal school age population.
Ambulatory rural school children in the Mombasa area with P. falciparum parasitaemia were examined and randomly assigned to treatment with one of three second-line antimalarials--amodiaquine, pyrimethamine/sulphadoxine (P/SD) and pyrimethamine/sulfalene (P/SL). Clinical signs and parasitaemia were followed daily for the first week and on days 14 and 28. WHO Mark II schizont inhibition tests were performed for all the above 3 drugs and chloroquine. The total number of cases was 73. The mean parasite density was 142.1 +/- 207; 102.7 +/- 166; 82.74 +/- 93 parasites per 300 WBC for amodiaquine, P/SD, and P/SL, respectively. In vitro tests showed a chloroquine resistance rate of 60% and no resistance to all of the second line drugs. Also, all children treated successfully cleared their parasitaemia with mean clearance rates of 2.05 +/- 0.57; 1.86 +/- 0.47; 2.05 +/- 0.50 days for amodiaquine, P/SD and P/SL, respectively. Even though, no difference in the effectiveness between the second line drugs used was found, reinfection rates as depicted by day 28 parasitaemia differed--amodiaquine 16%; P/SD 0%; and P/SL4.35%. This difference could be attributed to the difference in the pharmacokinetic properties of the drugs.
Hagos
B
B
Department of Pharmacy, University of Nairobi, Kenya.
Khan
B
B
Ofulla
A V
AV
Kariuki
D
D
Martin
S K
SK
D000293:Adolescent; D000655:Amodiaquine / Q000627:therapeutic use*; D002648:Child; D002738:Chloroquine / Q000627:therapeutic use*; D004338:Drug Combinations; D004351:Drug Resistance; D006801:Humans; D007630:Kenya / Q000453:epidemiology; D016778:Malaria, Falciparum / Q000097:blood / Q000188:drug therapy* / Q000469:parasitology; D008826:Microbial Sensitivity Tests; D011739:Pyrimethamine / Q000627:therapeutic use*; D012423:Rural Health; D013413:Sulfadoxine / Q000627:therapeutic use*; D013415:Sulfalene / Q000627:therapeutic use*
D004338:Drug Combinations; D000655:Amodiaquine; D013413:Sulfadoxine; D002738:Chloroquine; D013415:Sulfalene; D011739:Pyrimethamine