A trial of proguanil-dapsone in comparison with sulfadoxine-pyrimethamine for the clearance of Plasmodium falciparum infections in Tanzania.

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dc.contributor.authorMutabingwa, Theonest K.
dc.date.accessioned2020-10-13T07:41:49Z
dc.date.available2020-10-13T07:41:49Z
dc.date.issued2001
dc.description.abstractConsiderable levels of resistance to sulfadoxine-pyrimethamine (SP) have been reported in Plasmodium falciparum in north-eastern Tanzania, and the identification of a suitable antimalarial to replace SP is now a high priority. We conducted a trial in July 2000 to determine the efficacy of proguanil (PG) plus dapsone (DS), compared with that of SP, for the treatment of asymptomatic falciparum infection. A total of 220 children with parasitaemia ⩾ 2000 per μL completed the study; 112 had received a single dose of SP (dosage calculated for pyrimethamine 1·25 mg/kg and sulfadoxine 25 mg/kg) and 108 had taken PG 10 mg/kgwith DS 2·5 mg/kg each day for 3 days. Clearance of asexual parasites at day 7 was 14·3% with SP, but 93·5% with PG-DS. The remarkably high failure rate with SP was not associated with occurrence of leucine substitution at position 164 of the dhfr gene. Both treatment regimens were well tolerated. Compared with available data on another antifolate combination, chlorproguanil-dapsone (‘Lapdap’), PG-DS was slightly but significantly inferior in achieving parasite clearance (99·5% versus 93·5%). The estimated cost of a 3-day course of PG-DS treatment for a child weighing 18 kg is US $0.15. With the rising incidence of SP-resistant P. falciparum infection, PG-DS could provide an effective, affordable and already available therapeutic alternative for malaria in East Africa at least until chlorproguanil-dapsone is registered.en_US
dc.identifier.citationMutabingwa, T.K., Maxwell, C.A., Sia, I.G., Msuya, F.H.M., Mkongewa, S., Vannithone, S., Curtis, J. and Curtis, C.F., 2001. A trial of proguanil-dapsone in comparison with sulfadoxine-pyrimethamine for the clearance of Plasmodium falciparum infections in Tanzania. Transactions of the Royal Society of Tropical Medicine and Hygiene, 95(4), pp.433-438.en_US
dc.identifier.otherhttps://doi.org/10.1016/S0035-9203(01)90207-X
dc.identifier.urihttp://hdl.handle.net/123456789/653
dc.language.isoenen_US
dc.publisherTransactions of the Royal Society of Tropical Medicine and Hygieneen_US
dc.subjectMalariaen_US
dc.subjectPlasmodium falciparumen_US
dc.subjectTanzaniaen_US
dc.titleA trial of proguanil-dapsone in comparison with sulfadoxine-pyrimethamine for the clearance of Plasmodium falciparum infections in Tanzania.en_US
dc.typeArticleen_US

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