title: Short report: therapeutic efficacy of chloroquine combined with primaquine against Plasmodium falciparum in northeastern Papua, Indonesia.
abstract: Chloroquine combined with primaquine was evaluated for therapy of uncomplicated malaria caused by Plasmodium falciparum in nonimmune Javanese migrants to northeastern Papua, Indonesia. Subjects were randomized to treatment with standard chloroquine therapy (25 mg/kg in 3 doses over the course of 48 hours) with 30 mg primaquine administered daily for 28 days (n = 25) or a placebo of primaquine (n = 28). The 14-day cumulative incidence of therapeutic failure was 56% with primaquine and 79% with placebo (odds ratio [OR], 0.35; 95% confidence interval [CI], 0.1-1.3; P = 0.08). Primaquine administered daily created a marginally significant improvement in therapeutic efficacy at day 14, but not at day 7 (20% versus 36%; OR, 0.2; 95% CI, 0.1-1.8; P = 0.2) or day 28 (82% versus 93%; OR, 0.31; 95% Cl, 0.04-2.1; P = 0.23). This report corroborates studies suggesting that therapeutic doses of primaquine exert no discernible effect on parasitemia by P. falciparum.
authors.affiliation: US Naval Medical Research Unit No 2, American Embassy Jakarta, Indonesia. bairdjk@namru2.med.navy.mil
authors.forename: J Kevin
authors.initials: JK
authors.lastname: Baird
authors.forename: Iwa
authors.initials: I
authors.lastname: Wiady
authors.forename: Awalludin
authors.initials: A
authors.lastname: Sutanihardja
authors.lastname: Suradi
authors.lastname: Purnomo
authors.forename: Hasan
authors.initials: H
authors.lastname: Basri
authors.lastname: Sekartuti
authors.forename: Ester
authors.initials: E
authors.lastname: Ayomi
authors.forename: David J
authors.initials: DJ
authors.lastname: Fryauff
authors.forename: Stephen L
authors.initials: SL
authors.lastname: Hoffman
mesh_terms: D000962:Antimalarials / Q000627:therapeutic use*; D002738:Chloroquine / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D006801:Humans; D015994:Incidence; D007214:Indonesia; D016778:Malaria, Falciparum / Q000188:drug therapy*; D018512:Parasitemia / Q000453:epidemiology; D010919:Placebos; D011319:Primaquine / Q000627:therapeutic use*; D012008:Recurrence
chemical_list: D000962:Antimalarials; D010919:Placebos; D002738:Chloroquine; D011319:Primaquine