Response of children with Plasmodium falciparum to chloroquine and development of a national malaria treatment policy in Zaire

Trans R Soc Trop Med Hyg. 1988;82(3):353-7. doi: 10.1016/0035-9203(88)90113-7.

Abstract

In vivo sensitivity of Plasmodium falciparum to chloroquine was evaluated in 4 of 9 regions of Zaire in 1985 to develop a national strategy for treatment of malaria. Children less than 5 years of age were treated with either a single dose of chloroquine base, 10 mg/kg, or a dose of 25 mg/kg given over 3 d. A modified 7-day World Health Organization in vivo test was used with follow-up 2, 3 and 7 d after the start of treatment. 339 children were studied. In Bwamanda 92% of children were aparasitaemic 7 days after chloroquine, 10 mg/kg, but in Kinshasa only 44% were free of parasites after 25 mg/kg chloroquine. The mean drop in parasite density among those who did not clear parasites by day 7 was greater than 98% of the initial value. Although the parasite density decreased markedly, the failure of most subjects to become aparasitaemic indicated a marked decrease in parasite sensitivity since 1983. Only one child of 51 who were initially febrile remained febrile, although 14 (28%) of these had resistant parasites. The decrease in parasitaemia and temperature, even among children with resistant strains, led the Ministry of Health to recommend 25 mg/kg chloroquine as first line treatment for fever/malaria in their national malaria control plan. The plan includes drug sensitivity surveillance and a referral system for patients who do not respond to chloroquine treatment.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Animals
  • Child, Preschool
  • Chloroquine / administration & dosage
  • Chloroquine / therapeutic use*
  • Democratic Republic of the Congo
  • Drug Resistance
  • Female
  • Health Policy
  • Humans
  • Malaria / drug therapy*
  • Malaria / parasitology
  • Male
  • Plasmodium falciparum / drug effects
  • Public Health

Substances

  • Chloroquine