Abstract | BACKGROUND:
Chloroquine (CQ) or sulfadoxine-pyrimethamine (SP) monotherapy for Plasmodium falciparum often leads to therapeutic failure in Indonesia. Combining CQ with other drugs, like SP, may provide an affordable, available and effective option where artemisinin-combined therapies (ACT) are not licensed or are unavailable. METHODS: This study compared CQ (n = 29 subjects) versus CQ + SP (with or without primaquine; n = 88) for clinical and parasitological cure of uncomplicated falciparum malaria in the Menoreh Hills region of southern Central Java, Indonesia. Gametocyte clearance rates were measured with (n = 56 subjects) and without (n = 61) a single 45 mg dose of primaquine (PQ). RESULTS: After 28 days, 58% of subjects receiving CQ had cleared parasitaemia and remained aparasitaemic, compared to 94% receiving CQ combined with SP (p < 0.001). Msp-2 genotyping permitted reinfection-adjusted cure rates for CQ and CQ combined with SP, 70% and 99%, respectively (p = 0.0006). CONCLUSION:
Primaquine exerted no apparent affect on cure of asexual stage parasitaemia, but clearly accelerated clearance of gametocytes. CQ combined with SP was safe and well-tolerated with superior efficacy over CQ for P. falciparum parasitaemia in this study.
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Authors | Edith R Lederman, Jason D Maguire, Iwa W Sumawinata, Krisin Chand, Iqbal Elyazar, Lusi Estiana, Priyanto Sismadi, Michael J Bangs, J Kevin Baird |
Journal | Malaria journal
(Malar J)
Vol. 5
Pg. 108
(Nov 14 2006)
ISSN: 1475-2875 [Electronic] England |
PMID | 17105658
(Publication Type: Journal Article, Randomized Controlled Trial, Research Support, U.S. Gov't, Non-P.H.S.)
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Chemical References |
- Antimalarials
- Drug Combinations
- fanasil, pyrimethamine drug combination
- Sulfadoxine
- Chloroquine
- Primaquine
- Pyrimethamine
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Topics |
- Adolescent
- Adult
- Animals
- Antimalarials
(administration & dosage, therapeutic use)
- Chloroquine
(administration & dosage, therapeutic use)
- Drug Combinations
- Drug Therapy, Combination
- Female
- Humans
- Indonesia
(epidemiology)
- Malaria, Falciparum
(drug therapy, epidemiology)
- Male
- Middle Aged
- Plasmodium falciparum
- Primaquine
(administration & dosage, therapeutic use)
- Pyrimethamine
(administration & dosage, therapeutic use)
- Sulfadoxine
(administration & dosage, therapeutic use)
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