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Am. J. Trop. Med. Hyg., 80(2), 2009, pp. 199-201
Copyright © 2009 by The American Society of Tropical Medicine and Hygiene

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SHORT REPORT


Comparison of Chlorproguanil-Dapsone with a Combination of Sulfadoxine-Pyrimethamine and Chloroquine in Children with Malaria in Northcentral Nigeria

Oluwagbenga Ogunfowokan, Musa Dankyau, Aboi J. K. Madaki, AND Tom D. Thacher*
Department of Family Medicine, Jos University Teaching Hospital, Jos, Plateau State, Nigeria; Department of Family Medicine, Evangelical Church of West Africa Evangel Hospital, Jos, Plateau State, Nigeria; Department of Family Medicine, Mayo Clinic, Rochester, Minnesota

 

ABSTRACT

Effective and affordable treatment of malaria is critical in the face of resistance of Plasmodium falciparum to chloroquine (CQ) and sulfadoxine-pyrimethamine (SP). We conducted a randomized controlled trial comparing the efficacy of chlorproguanil-dapsone (CD) with a combination SP plus CQ in children in Nigeria less than five years of age with malaria. Of 264 children enrolled, 122 (89.7%) and 118 (92.2%) completed the study in the SP + CQ and CD groups, respectively. By day 3, 96 (78.7%) and 94 (79.7%) had cleared their parasitemia (P = 0.79), and 107 (87.7%) and 109 (92.4%) were symptom free (P = 0.32) in the SP + CQ and CD groups, respectively. Adequate clinical and parasitologic response at day 14 occurred in 111 (94.1%; 95% confidence interval [CI] = 91.6–95.7%) in the CD group and 113 (92.6%; 95% CI = 89.9–94.3%) in the SP + CQ group (P = 0.85). SP + CQ and CD had similar antimalarial efficacy and still provide affordable treatment of uncomplicated malaria in northcentral Nigeria.

Received May 28, 2008. Accepted for publication October 9, 2008.

Acknowledgments: We thank Drs. Bill Ardill, Joel Anthis, and Philip Andrew for their support and financial assistance, and Dr. N. B. Molta and Ugoya Pam (Parasitologic Unit, University of Jos) for assistance in analysis of blood samples.

* Address correspondence to Tom D. Thacher, Department of Family Medicine, Mayo Clinic; 200 First Street SW, Rochester, MN 55905. E-mail: thacher.thomas{at}mayo.edu

Authors’ addresses: Oluwagbenga Ogunfowokan, Department of Family Medicine, Evangelical Church of West Africa Evangel Hospital, Jos, Plateau State, Nigeria, and Department of Family Medicine, Jos University Teaching Hospital, PMB 2076, Jos, Plateau State, Nigeria, E-mail: gbengapaul2002{at}yahoo.com. Musa Dankyau, Evangelical Church of West Africa Evangel Hospital, PMB, 2238, Jos, Plateay State, Nigeria, E-mail: dankyau2{at}aol.com. Aboi J. K. Madaki, Department of Family Medicine, Jos University Teaching Hospital, PMB 2076, Jos, Nigeria, E-mail: aboikutak{at}yahoo.com. Tom D. Thacher, Department of Family Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, E-mail: thacher.thomas{at}mayo.edu.






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