Karwacki J J, Shanks G D, Suriyamongkol V, Watanasook C
Department of Medicine, Armed Forces Research Institute Medical Sciences, Bangkok, Thailand.
Southeast Asian J Trop Med Public Health. 1991 Mar;22(1):77-80.
383 Thai soldiers on the Thai-Cambodian border were entered into a randomized malaria chemoprophylactic trial. Proguanil (200 mg/day) combined with sulfamethoxazole (1000 or 1500 mg/day) were compared to a standard combination of weekly pyrimethamine/dapsone (Maloprim). Men receiving proguanil/sulfamethoxazole had a significantly lower malaria attack rate than those taking pyrimethamine/dapsone. This was true of both the first five-week phase in which 1000 mg of sulfamethoxazole was used (0.11 vs 0.26; p less than 0.001) and in the second ten weeks in which 1500 mg of sulfamethoxazole was used (0.13 vs 0.30; p less than 0.001). Combined relative efficacy indicated that proguanil/sulfamethoxazole was better than pyrimethamine/dapsone by 64% for Plasmodium vivax and by 38% for P. falciparum. Unenforced compliance as measured by returned pills was greater than 86% in both groups. No serious drug side-effects were observed. Proguanil/sulfamethoxazole may represent a useful chemoprophylactic option in areas of multiple drug-resistant malaria.
383名驻守在泰柬边境的泰国士兵参与了一项疟疾化学预防随机试验。将氯胍（200毫克/天）与磺胺甲恶唑（1000或1500毫克/天）联用，与每周服用乙胺嘧啶/氨苯砜（疟防片）的标准组合进行比较。服用氯胍/磺胺甲恶唑的男性疟疾发病率显著低于服用乙胺嘧啶/氨苯砜的男性。在使用1000毫克磺胺甲恶唑的前五周阶段（0.11对0.26；p小于0.001）以及使用1500毫克磺胺甲恶唑的后十周阶段（0.13对0.30；p小于0.001）均是如此。综合相对疗效表明，氯胍/磺胺甲恶唑对间日疟原虫的效果比乙胺嘧啶/氨苯砜好64%，对恶性疟原虫好38%。通过回收药丸衡量的非强制依从性在两组中均大于86%。未观察到严重药物副作用。在多重耐药疟疾地区，氯胍/磺胺甲恶唑可能是一种有用的化学预防选择。
