In the last decade, Plasmodium falciparum resistance to a number of commonly used
anti-malarials especially
chloroquine, has increased considerably. Newer
anti-malarial drugs are therefore being aggressively evaluated as alternatives. A randomized double-blind controlled trial was therefore undertaken, to compare the efficacy of
halofantrine to that of
metakelfin, in the treatment of moderately severe
infections of Plasmodium falciparum in an endemic
malaria area in Kenya. Three hundred and thirty five subjects with laboratory confirmed
malaria were recruited and randomized to receive treatment with either
halofantrine (171 subjects) or
metakelfin (164 subjects). Two thirds (66%) of the study subjects were under the age of five years, and were therefore considered to have minimal immunity. All study subjects were initially admitted to hospital for three days and then followed up as out-patients on days 7, 14, 21, and 28. The level of parasitaemia, the presence of
fever and the occurrence of adverse effects were evaluated.
Halofantrine was found to be comparable to
metakelfin in terms of resolution of
fever (mean time 45 and 51 hours respectively). No major adverse side effects were observed.
Halofantrine is a viable
drug in the treatment of uncomplicated P.
falciparum malaria.