Biological and Haematological Safety Profile of Oral Amodiaquine and Chloroquine in Healthy Volunteers with or without Plasmodium falciparum Infection in Northeast Tanzania

Amodiaquine (AQ); an effective antimalarial drug for uncomplicated malaria; has been greatly restricted after cases of life-threatening agranulocytosis and hepatic toxicity during prophylactic use. We conducted a hospital based open-label randomised clinical trial in 40 indigenous semi-immune healthy adult male volunteers with and without malaria parasites. The objective was to collect data on biological and haematological safety; tolerability; and parasitological efficacy to serve as baseline in the evaluation of the effectiveness of AQ preventive intermittent treatment against malaria morbidity in infants. Volunteers were stratified according to parasitaemia status and randomly assigned 20 participants each arm to three days treatment with either AQ or chloroquine (CQ). The level of difference of selected haematological and hepatological values pre-and post-trial were marginal and within the normal limits. Clinical adverse effects mostly mild and transient were noticed in 33.3CQ treated-aparasitaemic; 23.8of CQ treated-parasitaemic; 28.6of AQ-treated parasitaemic and 14.3of aparasitaemic receiving AQ. Amodiaquine attained 100parasitological clearance rate versus 70in CQ-treated volunteers. The findings indicate that there was no agranulocytosis or hepatic toxicity suggesting that AQ may pose no public health risk in its wide therapeutic dosage uses. Larger studies are needed to exclude rare adverse effects

Enquete sur le prurit a la chloroquine et ses facteurs favorisants au Mali

65 cas dus a la prise de chloroquine sont colliges en 13 mois lors d'une enquete prospective a l'Hopital du Point G de Bamako (Mali). La chloroquine est surtout prise a faible dose en automedication devant de la fievre; des cephalees et des troubles digestifs. Le prurit apparait en moins de 24 heures; dure moins de 72 heures et n'est pas calme par les antihistaminiques. Il est surtout observe chez les sujets; de milieu socio-professionnel eleve; presentant des antecedents personnels et familiaux de prurit a la chloroquine. Des antecedents de prurit au cours de la grossesse sont frequents. Un terrain allergique ne semble pas en cause. Aucune anomalie biologique ne caracterise cet effet secondaire. Le role favorisant de l'onchocercose; signale dans la litterature; n'est pas observe a Bamako

Chronic chloroquine use- A cause of complete heart block

There have been occasional reports of complete heart block in chronic use of chloroquine; in most of these cases this has followed chronic abuse. Self medication is common in Tanzania; where malaria is endemic and chloroquine is easily available in ordinary shops and pharmacies. This is a report of a patient who developed complete heart block; and poor vision following chronic chloroquine abuse