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Effects of Fansidar on Chloroquine-Resistant Plasmodium falciparum in Pakistan^*

G. Thomas Strickland, Amir A. Khaliq, Mohammad Sarwar, Hadi Hassan, Mohammad Pervez AND Emile Fox

Clinical Epidemiology Department, International Center for Medical Research and Training, Lahore, Pakistan
and International Health Program, University of Maryland School of Medicine, Baltimore, Maryland 21201

Fansidar (SP), a combination of sulfadoxine and pyrimethamine, was evaluated for its usefulness as a curative agent for treating individual malaria patients and for reducing the community reservoir of Plasmodium falciparum in 4 villages near Lahore, Pakistan, where resistance of 4-aminoquinolines has recently been reported. Following the end of the major malaria transmission season, we carried out a month-long mass treatment campaign during which SP was given to all available villagers who had parasitemias detected during a concurrent house-to-house malaria blood film survey. Of the 82 falciparum patients followed for 14 days after SP treatment, 80 (97.5%) had parasites sensitive to the investigated drug. Parasitemia clearance time after SP was remarkedly short (1.25 ± 0.53 days; mean ± SD). However, we were unable to reduce the parasite reservoir of P. falciparum and P. vivax in these villages, probably because we treated only 337, about one-third, of the parasitemic patients. We conclude that SP is an effective drug for treating individual malaria patients from areas in Pakistan where 4-aminoquinoline-resistant parasites are present, but that more research is needed for assessing its usefulness in reducing community reservoirs of malaria.

Accepted for publication September 7, 1985.

^* Address reprint requests to: Dr. G. T. Strickland, International Health Program, University of Maryland School of Medicine, Baltimore, Maryland 21201.