Efficacy of sulfadoxine/pyrimethamine for uncomplicated Plasmodium falciparum malaria in a small sample of Sudanese children

A prospective clinical trial was carried out to determine in vivo efficacy of sulfadoxine/pyrimethamine for the treatment of uncomplicated Plasmodium falciparum malaria in children in New Halfa. Forty patients were enrolled; 31 completed the 28-day follow-up. Six [19.4%] patients showed recurrence of parasitaemia during follow-up, while the rest [80.6%] cleared the parasites and responded fully to treatment. All the failures were late treatment failures. Parasite genotyping showed that 1 [16.7%] of the 6 cases of late parasitaemia was due to reinfection while the rest [83.4%] were due to true recrudescence. During the follow-up period 22.6% of patients showed gametocytaemia. The high level of treatment failure as well as gametocytaemia necessitates the introduction of artesunate in this combination therapy

Low-dose quinine for treatment of chloroquine-resistant falciparum malaria in Sudanese pregnant women

Pregnant Sudanese women who presented at a hospital in eastern Sudan with chloroquine-resistant falciparum malaria were randomly allocated to one of two quinine regimens: low-dose [10 mg/kg 2 times/day] [18 patients] or st and ard [10 mg/kg 3 times/day] [24 patients]. Treatment was for 7 days and follow-up for 28 days. Significantly fewer patients in the low-dose group reported vomiting and abdominal pain than the st and ard regimen group. Hypoglycaemia, preterm labour and recrudescence were slightly but not significantly higher in patients in the st and ard group than low-dose group. There were no significant differences between the groups in the mean time from admission to remission of fever and parasite clearance. We tentatively advocate the use of quinine 2 times/day to reduce side-effects and improve compliance