Journal of Vector Borne Diseases (Sep 2003)
Assessment of therapeutic efficacy of chloroquine and sulphadoxine-pyrimethamine in uncomplicated falciparum malaria
Abstract
A standardised protocol has been developed by World Health Organization (CDS/RBM/2002) toassess the efficacy of common antimalarials in the treatment of clinically manifested infection withuncomplicated P. falciparum malaria for areas with low to moderate transmission. The therapeuticefficacy protocol is based on clinical and parasitological responses of the patients and it has thepurpose of determining the practical efficacy of the drug regimen in study areas with the ultimateobjective of ascertaining its continued usefulness or the necessity for replacing it in the routinetreatment. Present study has been conducted at seven sites—Kathiatali and Simonabasti of DistrictNowgaon, Assam; Sonapur and Boko of District Kamrup, Assam; Keonjhar Town, Padampur andBasudebpur of District Keonjhar, Orissa. In order to reduce the patient recruitment time, health centreclose to well-defined community was identified to conduct the activities at peak malaria seasonby selecting local pockets and organising mobile clinics. Microscopically confirmed cases of P. falciparumwere enrolled according to the criteria for inclusion and exclusion. Treatment with recommendeddrug was given under supervision and a follow-up schedule at various intervals for 28days was maintained. In chloroquine (CQ) study areas, wherever patients showed treatment failure,they were treated with second line drug—sulphadoxine-pyrimethamine (SP) combination and thenfollowed-up as per study protocol. It was observed that 30% cases showed treatment failure to CQin District Nowgaon, where revised drug policy has already been introduced. In Kamrup district,treatment failure with CQ was found to be less than 25%, which denotes the said regimen is still effective.Almost all the patients from Padampur and Basudebpur of District Keonjhar responded toCQ, treatment failure was noticed only in two patients (3%). The antifolate combination found to befully effective as second line and also as first line wherever revised drug policy has been introduced.
