Halofantrine versus quinine-Fansidar combination in the treatment of post-chloroquine falciparum parasitaemia.
The standard first-line treatment for malaria in adults in Papua New Guinea is chloroquine; for severe and treatment-failure malaria standard therapy is a combination of quinine and Fansidar (sulphadoxine-pyrimethamine). These standard treatments are currently under revision. The present study evaluated the effect of halofantrine in treatment-failure falciparum malaria in adults in Port Moresby compared to standard therapy. In the halofantrine group all parasites were cleared by day 5 after starting therapy, in the quinine-Fansidar group by day 7. There was no evidence of recurrence of parasitaemia during the 21-day follow-up in either group. Nausea was associated with halofantrine use in 68% of patients. In the quinine-Fansidar group 79% had muffled deafness, 32% tinnitus and 26% dizziness; 32% of patients withdrew from treatment on day 2 because of intolerance to quinine. Halofantrine in this study population provided an efficacy against treatment-failure falciparum malaria similar to that of quinine-Fansidar, with a more favourable profile of adverse effects.
Department of Basic Medical Sciences, Faculty of Medicine, University of Papua New Guinea, Port Moresby.
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Hombhanje
D000328:Adult; D004338:Drug Combinations; D005260:Female; D006801:Humans; D016778:Malaria, Falciparum / Q000188:drug therapy*; D008297:Male; D010219:Papua New Guinea; D010616:Phenanthrenes / Q000627:therapeutic use*; D011739:Pyrimethamine / Q000627:therapeutic use*; D011803:Quinine / Q000627:therapeutic use*; D013413:Sulfadoxine / Q000627:therapeutic use*
D004338:Drug Combinations; D010616:Phenanthrenes; C001205:fanasil, pyrimethamine drug combination; D013413:Sulfadoxine; D011803:Quinine; C023768:halofantrine; D011739:Pyrimethamine