RESUMO
The in vivo sensitivity of Plasmodium falciparum to chloroquine and sulfadoxine/pyrimethamine was evaluated in children under 5 years of age in two areas of southern Nigeria in 1987. A modification of the WHO Standard Field and Extended Tests (in vivo) was used, with follow-up on days, 2, 3, 7, and 14 after treatment with 25 mg chloroquine per kg body weight given over 3 days, or with standard doses of sulfadoxine/pyrimethamine. Clinical and parasitological evaluations were performed
At Igbo Ora, in Oyo State, where by day 7 chloroquine was clinically successful in 94.4 per cent of 36 children and sulfadoxine/pyrimethamine in 91.7 per cent of 36 children, there were no parasitological failures in either treatment group. Fever regressed significantly more rapidly with chloroquine than with sulfadoxine/pyrimethamine. At Oban, in Cross River State, initial parasite densities decreased markedly with the chloroquine regimen but 63.6 per cent of 44 children were parasitological failures on day 3, 7, or 14; and all of the 26 children who failed parasitologically and completed follow-up were successfully treated with sulfadoxine/pyrimethamine. By day 7, clinical success was demonstrated for 77.3 per cent of the children treated with chloroquine. The in vitro sensitivity to chloroquine, quinine, and mefloquine at Igbo Ora ...(AU)
Assuntos
Malária/tratamento farmacológico , Malária/epidemiologia , Malária/prevenção & controle , Plasmodium falciparum , Cloroquina/administração & dosagem , Cloroquina/terapia , Cloroquina/farmacocinética , Quimioterapia Combinada , Resistência Microbiana a Medicamentos , Pirimetamina/administração & dosagem , Pirimetamina/terapia , Pirimetamina/farmacocinética , NigériaRESUMO
Pyrimethamine and primaquine were distributed house-to-house, every two weeks, for a two-year period. The last insecticide spraying of the study area took place 10 months before drug distribution began. No vector control measures were operative during the period of drug distribution. As a result, the malaria prevalence which was 17.4 per cent at the beginning of the trial, dropped to 2.4 per cent in eight weeks and to about 1 per cent in another eight weeks and persisted at the latter level for the remainder of the 49 bi-weekly cycle trial. Clinical malaria disappeared
Although P. vivax malaria disappeared from the study area for 32 weeks in the second year of trial, transmission of P. falciparum malaria was greatly reduced but never completely eliminated
Parasite importation by visitors and new settlers was a constant problem. About 2.1 per cent of all new persons encountered in the area had malaria when first seen
No side effects of suficient severity to prevent taking the drug combination in subsequent cycles occurred, except for complaints of headache and nausea which were ascribed to the drug
Malaria prevalence in the study area decreased about 94 per cent while other areas in the Republic of Panama and the Canal Zone experienced an increased prevalence during the first year of the study(AU)