Randomised trial of pyronaridine versus chloroquine for acute uncomplicated falciparum malaria in Africa.
BACKGROUND
The spread of chloroquine resistance poses a serious problem in Africa, where falciparum malaria transmission is the highest in the world. Pyronaridine, an acridine derivative, has been used successfully to treat malaria in China for over 20 years. We compared the efficacy of pyronaridine and chloroquine in African adult patients with acute uncomplicated falciparum malaria in Yaoundé, Cameroon, where chloroquine resistance is well established.


METHODS
96 patients were randomly assigned treatment with chloroquine 25 mg/kg or pyronaridine 32 mg/kg, both orally and divided over 3 days. Patients were followed up for at least 14 days on an outpatient basis. Analysis was by on-active-treatment.


RESULTS
After losses from follow-up (11) or because of self-medication with quinine (four), 41 patients treated with chloroquine and 40 treated with pyronaridine were analysed. Parasite clearance during the 14-day follow-up with chloroquine and pyronaridine was 44% and 100%, respectively. All patients treated with pyronaridine were afebrile by day 3, and parasitaemia cleared by day 4. No serious drug-related side-effects were noted in pyronaridine-treated patients.


CONCLUSIONS
Pyronaridine was rapidly effective and well-tolerated in African patients with acute, uncomplicated falciparum malaria and may represent an alternative drug against chloroquine-resistant malaria.
Ringwald
P
P
Laboratoire de Recherches sur le Paludisme, Organisation de Coordination pour la Lutte contre des Endémies en Afrique Centrale (OCEAC), Yaoundé, Cameroon.
Bickii
J
J
Basco
L
L
D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000818:Animals; D000962:Antimalarials / Q000627:therapeutic use*; D002163:Cameroon; D002738:Chloroquine / Q000627:therapeutic use*; D004351:Drug Resistance; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016778:Malaria, Falciparum / Q000188:drug therapy* / Q000469:parasitology; D008297:Male; D008875:Middle Aged; D009287:Naphthyridines / Q000627:therapeutic use*; D010963:Plasmodium falciparum / Q000187:drug effects; D016896:Treatment Outcome
D000962:Antimalarials; D009287:Naphthyridines; D002738:Chloroquine; C027871:pyronaridine