title: A comparative study of the efficacies of chloroquine and a pyrimethamine-dapsone combination in clearing Plasmodium falciparum parasitaemia in school children in Tanzania.
abstract: A randomized study on the in vivo efficacies of chloroquine and a pyrimethamine-dapsone combination (Maloprim) in clearing P. falciparum parasitaemia was carried out in 77 asymptomatic semi-immune schoolchildren in the Kilombero District of Tanzania. Children were randomized to receive either chloroquine at a dose of 25 mg/kg over three days, or Maloprim (6.25 mg pyrimethamine + 50 mg dapsone for children under 10 years, and 12.5 mg pyrimethamine + 100 mg dapsone for children 10 or more years old) as a single dose. Children were followed-up for malaria parasitaemia at days 2, 7 and 14 after screening, randomization and treatment. The slide positivity rate was lower in the Maloprim group at all cross-sectional surveys (23 vs 37% at day 2; 9 vs 20% at day 7; 21 vs 32% at day 14) but none of these differences reached statistical significance. No cases in the Maloprim group showed RII resistance, whereas in the chloroquine group, 2 cases showed RII resistance and a further 2 cases RIII resistance (6%). No major side-effects were reported. The combination of pyrimethamine-dapsone appears to be a better choice than chloroquine as a chemoprophylactic regimen for malaria in this area. Although they need to be confirmed in a larger study, these results may be of interest to the policy-makers as well as researchers.
authors.affiliation: Ifakara Centre, Tanzania.
authors.forename: H
authors.initials: H
authors.lastname: Mshinda
authors.forename: F
authors.initials: F
authors.lastname: Font
authors.forename: R
authors.initials: R
authors.lastname: Hirt
authors.forename: M
authors.initials: M
authors.lastname: Mashaka
authors.forename: C
authors.initials: C
authors.lastname: Ascaso
authors.forename: C
authors.initials: C
authors.lastname: Menendez
mesh_terms: D000962:Antimalarials / Q000627:therapeutic use*; D002648:Child; D002738:Chloroquine / Q000627:therapeutic use*; D003622:Dapsone / Q000627:therapeutic use*; D004338:Drug Combinations; D005260:Female; D006801:Humans; D016778:Malaria, Falciparum / Q000188:drug therapy*; D008297:Male; D011739:Pyrimethamine / Q000627:therapeutic use*; D011897:Random Allocation; D013636:Tanzania
chemical_list: D000962:Antimalarials; D004338:Drug Combinations; C001678:Maloprim; D002738:Chloroquine; D003622:Dapsone; D011739:Pyrimethamine