Response of children with Plasmodium falciparum to chloroquine and development of a national malaria treatment policy in Zaire.

Journal Article (Journal Article)

In vivo sensitivity of Plasmodium falciparum to chloroquine was evaluated in 4 of 9 regions of Zaire in 1985 to develop a national strategy for treatment of malaria. Children less than 5 years of age were treated with either a single dose of chloroquine base, 10 mg/kg, or a dose of 25 mg/kg given over 3 d. A modified 7-day World Health Organization in vivo test was used with follow-up 2, 3 and 7 d after the start of treatment. 339 children were studied. In Bwamanda 92% of children were aparasitaemic 7 days after chloroquine, 10 mg/kg, but in Kinshasa only 44% were free of parasites after 25 mg/kg chloroquine. The mean drop in parasite density among those who did not clear parasites by day 7 was greater than 98% of the initial value. Although the parasite density decreased markedly, the failure of most subjects to become aparasitaemic indicated a marked decrease in parasite sensitivity since 1983. Only one child of 51 who were initially febrile remained febrile, although 14 (28%) of these had resistant parasites. The decrease in parasitaemia and temperature, even among children with resistant strains, led the Ministry of Health to recommend 25 mg/kg chloroquine as first line treatment for fever/malaria in their national malaria control plan. The plan includes drug sensitivity surveillance and a referral system for patients who do not respond to chloroquine treatment.

Full Text

Duke Authors

Cited Authors

  • Paluku, KM; Breman, JG; Moore, M; Ngimbi, NP; Sexton, JD; Roy, J; Steketee, RW; Weinman, JM; Kalisa-Ruti, ; ma-Disu, M

Published Date

  • 1988

Published In

Volume / Issue

  • 82 / 3

Start / End Page

  • 353 - 357

PubMed ID

  • 3068841

International Standard Serial Number (ISSN)

  • 0035-9203

Digital Object Identifier (DOI)

  • 10.1016/0035-9203(88)90113-7

Language

  • eng

Conference Location

  • England