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

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  • 1 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
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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.

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