Journal Article

Chloroquine versus Sulfadoxine-Pyrimethamine for Treatment of <i>Plasmodium falciparum</i> Malaria in Savannakhet Province, Lao People's Democratic Republic: An Assessment of National Antimalarial Drug Recommendations

Mayfong Mayxay, Paul N. Newton, Maniphono Khanthavong, Pongvongsa Tiengkham, Rattanaxay Phetsouvanh, Samlane Phompida, Alan Brockman and Nicholas J. White

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 37, issue 8, pages 1021-1028
Published in print October 2003 | ISSN: 1058-4838
Published online October 2003 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/377734
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

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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.

Journal Article.  4698 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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