The Response of P.falciparum to 4-Amonioquinolines and Pyrimethamine sulfadoxine in 6 sites scattered throughout Uganda

ABSTRACT

Due to the absence of audience reprots from Uganda on the Chloroquine (CQ) treatment failure of P.falciparum and Pyrimethamine sulfadoxine (PSD) combination; the need for a study to demonstrate the response for P.falciparum to these drugs was obvious. We accordingly assessed the response of P.falciparum malaria in primary school children from six sites scattered throughout Uganda during the month of July and Agust 1988. The standardised WHO in vivo and in vitro micro test methods were employed. A total of 3999 primary school children were screened from the six sites and of these 780(20) had malaria. While Arua had the highest rate of CQ sensitivity of 97.2; Kampala had the lowest rate of 60.5. R3 cases were detected at only two of the six sites namely Kampala with 1 case (2.3) and Jinja with also one case (2.9). PSD were sensitive by day 7 but 3 of the 60 cases (5) become parasitaemic by day 7. In vitro P. falcuparum isolates were significantly more sensitive to amodiaquine (AQ) at all sites with a mean EC 99 of 6.443u mol/L compared to 347.7u mol/L for CQ (p0.001). There was correlation between the in vitro sensitivities. We; therefore; recommend that CQ should continue to be the first line drug for the treatment of malaria in Uganda but may use PSD or AQ for slide confirmed P. falciparum resistant to CQ as the second line drugs. Quinine should also be readily available for malaria unrespondive to CQ. Source Uganda Med. J. Vol. 8 no. 2+4; Sept.-Dec. 1991