AB664         AUDIT OF EFFICACY OF SULFADOXINE/PYRIMETHAMINE COMBINED WITH CHLOROQUINE AT SINGLE FOURTEEN-DAY FOLLOW-UP

Author(s): 
Vaughan Williams CH, la Cock C, Henry GFJ, Ross AJ
INGWAVUMA, SOUTH AFRICA
Text: 
Summary Objective:
To assess the efficacy of the present first line treatment regime for uncomplicated falciparum malaria of sulfadoxine/pyrimethamine combined with chloroquine.
Design: A before-after study. Setting: Ndumo Clinic, Ingwavuma District, October 2000 Study Group. 55 patients presenting to Ndumo clinic with uncomplicated malaria and malaria trophozoites visible on thin film. Main outcome measures: Trophozoite count on thick film at day 14.
Results: 37 patients returned for 14 day follow-up of which 15 still had trophozoites on thick film. Symptoms of most patients at day 0 and day 14 were mild, parasite counts before and after treatment were low and trophozoites were atypical.
Conclusions:
There appears to be an unacceptably high day 14 failure rate with the combination of sulfadoxine/ pyrimethamine and chloroquine. The mildness of symptoms, low parasite counts and atypical trophozoites suggest immunity to falciparum malaria amongst the local population. With few antimalarials to chose from, the difficult question as to future treatment of uncomplicated malaria arises.