Sulfadoxine-Pyrimethamine for the Treatment of Acute Malaria in Children in Papua New Guinea

I. Plasmodium falciparum

Brian DarlowPapua New Guinea Institute of Medical Research, Madang General Hospital, P.O. Box 378, Madang, Papua New Guinea

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Helena VrbovaPapua New Guinea Institute of Medical Research, Madang General Hospital, P.O. Box 378, Madang, Papua New Guinea

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Sean GibneyPapua New Guinea Institute of Medical Research, Madang General Hospital, P.O. Box 378, Madang, Papua New Guinea

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Damien JolleyPapua New Guinea Institute of Medical Research, Madang General Hospital, P.O. Box 378, Madang, Papua New Guinea

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John StacePapua New Guinea Institute of Medical Research, Madang General Hospital, P.O. Box 378, Madang, Papua New Guinea

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Michael AlpersPapua New Guinea Institute of Medical Research, Madang General Hospital, P.O. Box 378, Madang, Papua New Guinea

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Chloroquine-resistant Plasmodium falciparum malaria is increasing in prevelance in Papua New Guinea and alternative therapies for acute malaria are being sought. A trial of sulfadoxine-pyrimethamine for the treatment of acute falciparum malaria in children has been carried out in Madang, Papua New Guinea. Eighty-five children were treated with sulfadoxine-pyrimethamine, either alone or in combination with a single 10 mg/kg dose of chloroquine. Of 78 children completing 28-days follow-up, treatment failures occurred in 15 (19.2%) and of these, 8 (10.3%), are believed to be sulfadoxine-pyrimethamine resistant; the others remain equivocal. There was no advantage in this study in combining a single dose of chloroquine with sulfadoxine-pyrimethamine; indeed, this combination was associated with an increased incidence of vomiting. It is argued that sulfadoxine-pyrimethamine should not become the standard presumptive treatment for acute malaria in Papua New Guinea.

Author Notes

Present address: Department of Paediatrics, Christchurch Hospital, Private Bag, Christchurch, New Zealand.

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