Comparison of Sulfadoxine-Pyrimethamine With and Without Chloroquine for Uncomplicated Malaria in Nigeria

Abstract

While resistance to older antimalarials is increasingly common, newer antimalarials are still not widely available or affordable in much of Africa. Older antimalarials used in combination might be adequately effective in treating uncomplicated malaria. The objective of this study was to determine whether the combination of sulfadoxine-pyrimethamine (SP) and chloroquine (CQ) is superior to SP alone in the treatment of uncomplicated Plasmodium falciparum malaria in Nigerian patients. We recruited subjects with malaria, defined as the presence of fever and parasitemia > 2,000/microL, from the outpatient department of a Nigerian teaching hospital. We alternately assigned 280 subjects to receive SP with or without CQ. We assessed clinical and parasitologic responses on days 1, 2, 3, 7, and 14. A total of 114 in the SP + CQ group and 116 in the SP group completed the study. By day 3, 97 (75%) in the SP + CQ group and 52 (42%) in the SP group had cleared their parasitemia (P < 0.001); by day 14, 112 (98%) and 67 (58%), respectively, had cleared their parasitemia (P < 0.001). By day 3, 82 (63%) in the SP + CQ group and 20 (16%) in the SP group were symptom free (P < 0.001). When a modified World Health Organization clinical classification system was used, adequate clinical response occurred in 99 (87%) and 61 (53%) of those in the SP + CQ and SP groups, respectively. RI, RII, and RIII resistance to SP + CQ was 7.9%, 3.5%, and 1.8%, respectively, whereas resistance to SP was 23%, 17%, and 5%, respectively. Combined SP + CQ is superior to SP alone for treatment of uncomplicated malaria in Nigerian patients and may prolong the usefulness of these readily available and affordable drugs.

The efficacy of sulfadoxine–pyrimethamine alone and in combination with chloroquine for malaria treatment in rural Eastern Sudan: the interrelation between resistance, age and gametocytogenesis

“…1998). However, a recently published work from West Africa, Nigeria, had showed the opposite, where the combination of CQ with SP, significantly improved the efficacy of the later in the treatment of UM (Pitmang et al. 2005).…”

A Comparison of Iron and Folate with Folate Alone in Hematologic Recovery of Children Treated for Acute Malaria

“…We used a combination of sulfadoxine-pyrimethamine and chloroquine for treatment of acute malaria, which at the time of our study had an adequate clinical response rate of 87% in our setting. 26 The anti-inflammatory effect of chloroquine may promote the remobilization of iron sequestered in macrophages and result in more rapid recovery from malarial anemia. F igure 2.…”

“…26 Parents were instructed to return with their children in four weeks or sooner if there was any problem. All parents were counseled on the use of insecticide-treated bed nets and other preventive measures against malaria.…”

Malaria Pasca Tsunami di Pulau Weh

“…Sedikit berbeda dengan penelitian di daerah endemis yang dilakukan pada tahun 2005 di Nigeria, dimana semua penderita malaria menderita demam, yang disertai dengan pusing (69,6%) dan gangguan pencernaan (50,4%). 8 Demam sebagai gejala klinis lebih bersifat subjektif. Hal itu terlihat dari 231 orang yang mengalami kenaikan suhu tubuh (tanda klinis), hanya 159 orang yang mengeluh demam (gejala klinis) atau 72 orang (32,1%) tanpa keluhan demam sama sekali.…”