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Comparison Of Chloroquine, Pyrimethamine And Sulfadoxine, And Chlorproguanil And Dapsone As Treatment For Falciparum Malaria In Pregnant And Non-Pregnant Women, Kakamega District, Kenya

Monique Keuter, Annemiek Van Eijk, Marjan Hoogstrate, Maarten Raasveld, Marcel Van De Ree, Wilfreda A. Ngwawe, William M. Watkins, Joab B. O. Were and A. David Brandling-Bennett
BMJ: British Medical Journal
Vol. 301, No. 6750 (Sep. 8, 1990), pp. 466-470
Published by: BMJ
Stable URL: http://www.jstor.org/stable/29708873
Page Count: 5
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Since scans are not currently available to screen readers, please contact JSTOR User Support for access. We'll provide a PDF copy for your screen reader.
Comparison Of Chloroquine, Pyrimethamine And Sulfadoxine, And Chlorproguanil And Dapsone As Treatment For Falciparum Malaria In Pregnant And Non-Pregnant Women, Kakamega District, Kenya
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Abstract

Objective—To compare treatment and protection against falciparum malaria in pregnant and non-pregnant women with three drug regimens. Design—Prospective intervention study with six weeks' follow up. Patients received one of three drug regimens in order of entry. Setting—Primary care hospital and secondary girls' school in rural western Kenya. Patients—158 Of 988 pregnant women (89 primigravid and 69 multigravid) in the third trimester and 105 of 1488 non-pregnant schoolgirls of reproductive age were parasitaemic (more than 500 asexual forms/μl. These women were divided into three treatment groups by gravid state. Interventions—Women were treated with chloroquine base 25 mg/kg over three days or pyrimethamine 75 mg and sulfadoxine 1500 mg as a single dose or chlorproguanil 1.2 mg/kg and dapsone 2.4 mg/kg as a single dose. Main outcome measures—Parasitaemia and haemoglobin concentrations measured at seven day intervals for six weeks. Results—Primigravid women were more likely to be parasitaemic on follow up than multigravidas or nulligravidas, whose response was about the same. Parasites did not clear by day 7 in primigravidas in six (20%) of 30 who received chloroquine, three (8%) of 35 treated with pyrimethamine and sulfadoxine, and none of 23 treated with chlorproguanil and dapsone. At day 28, 83%, 19%, and 67% of primigravidas in these treatment groups were parasitaemic. Haemoglobin concentrations rose in all women, but improvement was sustained only in women who remained free of parasites. Conclusions—Clearance of parasites was better with either pyrimethamine and sulfadoxine or chlorproguanil and dapsone than with chloroquine. Longest protection was obtained with pyrimethamine and sulfadoxine.

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