Halofantrine and primaquine for radical cure of malaria in Irian Jaya, Indonesia.

Abstract

The combination of halofantrine and primaquine therapies was calculated as a regimen for achieving radical curve of falciparum or vivax malaria in Irian Jaya, Indonesia, and compared with combined chloroquine and primaquine therapies. The patients who volunteered for the study [adult, male, Indonesian immigrants with no previous exposure to endemic malaria, normal glucose-6-phosphate dehydrogenase (G6PD) activity, uncomplicated malaria illness, no prior use of antimalarials, and parasitaemias of 0.001%-1.1%] were randomized to receive either halofantrine (24 mg base/kg bodyweight, in three equal doses over 12 h) or chloroquine (25 mg base/kg bodyweight over 48 h, in doses of 10, 10 and 5 mg base/kg at 24-h intervals). Each patient also received concurrent daily primaquine (0.5 mg base/kg bodyweight) for 14 days followed by the same dose on alternate days to day 28. A recurrent parasitaemia during the 28 days of follow-up constituted drug failure. Of the 40 cases of falciparum malaria and 26 cases of vivax malaria treated with halofantrine-primaquine, none had a recurrent parasitaemia (100% efficacy). In contrast, 20 of 30 patients with falciparum malaria and three of 27 with vivax malaria had recurrent parasitaemias after chloroquine-primaquine, giving efficacies of 33% and 89%, respectively. Halofantrine-primaquine was significantly more effective than chloroquine-primaquine against falciparum malaria (P < 0.001) but was similarly efficacious against vivax malaria (P = 0.23). On average, fever associated with falciparum or vivax malaria cleared 17 h faster with halofantrine-primaquine (P < 0.01) although there were no significant differences (P > 0.4) in parasite-clearance times between the two regimens. The halofantrine-primaquine regimen was also associated with a more rapid and significant decline in malaria-related physical complaints.

• Authors: D J Fryauff, J K Baird, H Basri, I Wiady, Purnomo, M J Bangs, B Subianto, S Harjosuwarno, E Tjitra, T L Richie, S L Hoffman
• Journal: Annals of tropical medicine and parasitology (Ann Trop Med Parasitol) Vol. 91 Issue 1 Pg. 7-16 (Jan 1997) ISSN: 0003-4983 [Print] England
• PMID: 9093424 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial, Research Support, U.S. Gov't, Non-P.H.S.)

Chemical References

• Antimalarials
• Phenanthrenes
• Chloroquine
• Primaquine
• halofantrine

Topics

• Adult
• Antimalarials (therapeutic use)
• Chloroquine (therapeutic use)
• Drug Therapy, Combination
• Follow-Up Studies
• Humans
• Indonesia
• Malaria, Falciparum (drug therapy, physiopathology)
• Malaria, Vivax (drug therapy, physiopathology)
• Male
• Parasitemia (drug therapy)
• Phenanthrenes (therapeutic use)
• Primaquine (therapeutic use)
• Recurrence
• Treatment Outcome