Cotrimoxazole for childhood febrile illness in malaria-endemic regions

The efficacy of co-trimaxozole for the treatment of Plasmodium falciparum parasitaemia in children younger than 5 years of age was evaluated in Malawi. 46 children with P falciparum parasitaemia; 37 percent of whom also met clinical criteria for acute respiratory tract infection; were treated with 20 mg/kg co-trimaxozole twice daily for five days. Parasitaemia (mean clearance time 2.7 days) and syptoms were rapidly abolished and improvement was maintained during the follow-up 14 days. Co-trimaxozole may be an effecitve single treatment for febrile illness in young children in areas where malaria is endemic; resources are few; and diagnosis must rely on clinical findings alone

In vivo efficacy of chloroquine treatment for Plasmodium falciparum in Malawian children under five years of age

In 1984 the government of Malawi instituted a program to reduce malaria mortality and morbidity in children less than 5 years of age as a part of the Combatting Childhood Communicable Diseases (CCCD) program. To define the appropriate malaria therapy regimen; investigators used a quality assurance design in a simplified 7-day in vivo drug response study with follow-up observations on day 2 (D2) ; D3; and D7 after the initial day of the study (D0). The efficacy of oral chloroquine was assessed in 224 children who were enrolled at 6 sites; 2 in each of the 3 administrative regions of Malawi. Parasitological failure; defined as failure of parasitemia to decrease by 75 percent of the value by D3 or presence of any detectable parasitemia on D7; ranged from 41 percent -65 percent following administration of chloroquine 25 mg (base)/kg. However; only 8 percent of children who were parasitemic on D7 were febrile or judged to be ill. Considering these therapeutic results and the higher cost and limited availability of alternative therapies; chloroquine 25 mg/kg therapy was adopted as the primary therapy for malaria