Short course of quinine plus a single dose of sulfadoxine/pyrimethamine for Plasmodium falciparum malaria.

BACKGROUND

Quinine remains the treatment of choice in hospitalized malaria cases; however, adverse reactions and the long treatment duration of 7 days often hamper its adequate use. Shortening the treatment by adding sulfadoxine/pyrimethamine may enhance compliance and reduce side effects. We aimed to assess the efficacy of a 3-day course of quinine plus a single dose of sulfadoxine/pyrimethamine for the treatment of non-severe hospitalized malaria cases in Lambaréné, Gabon.

METHODS

Fifty children aged between 2 and 7 years received quinine dihydrochloride (12 mg/kg every 12 hours for 72 hours), and then a single dose of oral SP (500 mg/25 mg tablet) was given according to weight category. The children were hospitalized for the duration of the treatment and until two consecutive blood smears were negative for malaria parasites. The follow-up period lasted 28 days.

RESULTS

Parasites were cleared after 66 hours (SD: 15 hours) and the fever after 46 hours (SD: 24 hours). All patients evaluable by day 28 were negative for malaria parasites (100% efficacy rate, 95% CI: 0.92-1). Only two patients out of 49 had gametocytemia on days 7 and 14. There was no adverse event probably or possibly attributable to the study drugs.

CONCLUSIONS

A very high efficacy can be reached using a 3-day course of quinine plus a single dose of sulfadoxine/pyrimethamine for the treatment of non-severe hospitalized malaria cases in our study area.