Chloroquine versus sulfadoxine-pyrimethamine for treatment of Plasmodium falciparum malaria in Savannakhet Province, Lao People's Democratic Republic: an assessment of national antimalarial drug recommendations.

Journal article

The in vivo efficacies of the Lao People's Democratic Republic (Laos) nationally recommended antimalarial agents--chloroquine and sulfadoxine-pyrimethamine-were assessed in a randomized, comparative trial that involved 100 patients with uncomplicated Plasmodium falciparum malaria who were followed for 42 days after starting treatment. Despite a shorter mean time to fever clearance associated with administration of chloroquine (mean time to clearance, 35.6 h; 95% confidence interval [CI], 26.3-45.0 h), compared with that associated with sulfadoxine-pyrimethamine (61.1 h; 95% CI, 50.9-71.3 h; P<.001), treatment failures were twice as frequent among patients receiving chloroquine therapy than among those receiving sulfadoxine-pyrimethamine therapy (36% vs. 18%; P=.02). Of 23 treatment failures, 10 (43%) were high grade. Treatment failure rates among children (age range, 5-15 years) were 4.9 times higher (95% CI, 2-12) than those among adults (P<.0001). Gametocytemia after antimalarial treatment was associated with receipt of sulfadoxine-pyrimethamine therapy and with treatment failure (P=.009). The efficacy of both chloroquine and sulfadoxine-pyrimethamine in Laos is unsatisfactory.

Authors: Mayxay, M; Newton, P; Khanthavong, M; Tiengkham, P; Phetsouvanh, R

• Publication status: Published
• Journal: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
• Volume: 37
• Issue: 8
• Pages: 1021-1028
• Publication date: 2003-10-01
• DOI: 10.1086/377734
• EISSN: 1537-6591
• ISSN: 1058-4838
• Language: English
• Keywords: Laos; Animals; Malaria, Falciparum; Antimalarials; Chloroquine; Humans; Male; Drug Combinations; Health Planning Guidelines; Sulfadoxine; Drug Resistance; Adult; Treatment Failure; Female; Pyrimethamine; Adolescent; Treatment Outcome