Treatment of falciparum malaria in Thai children

Abstract

141 children with falciparum malaria admitted to the Hospital for Tropical Diseases in Bangkok were analysed. They were treated with one of the 5 regimes of antimalarials, and the dosage of each case was adjusted to the body surface area from the adult basic dosage: (i) Chloroquine 1500 mg base total over a period of 3 days; (ii) Sulfadoxine 1000 mg and pyrimethamine 50 mg (Fansidar 2 tablets) a single oral dose; (iii) Fansidar 2 tablets plus chloroquine 1500 mg base total over 3 days; (iv) Fansidar 2 tablets single oral dose plus quinine 500 mg base 8 hourly for 3 days; (v) Fansidar 2 tablets single oral dose plus quinine 500 mg base 8 hourly for 5 days. Of the 25 children treated with chloroquine, only one case (4.0%) showed radical cure while 11 cases (44.0%) showed RI failure, 7 cases (28.0%) RII, and 6 cases (24.0%) RIII. Out of 30 cases treated with a single dose of Fansidar, 23 cases (76.7%) were cured, while 5 cases (16.7%) showed RI failure and 2 cases (6.7%) RIII. From a total of 23 cases treated with Fansidar and chloroquine, 15 cases (65.2%) were cured, while 6 cases (26.1%) showed RI failure and 2 cases (8.7%) RII. Of the 31 cases treated with Fansidar and quinine, 21 cases (67.7%) were cured, while 9 cases (29.0%) showed RI failure and 1 case (3.2%) RII and of the 32 cases treated with a single dose Fansidar and quinine for 5 days, 29 (90.6%) were cured while 3 cases (9.4%) showed RI failure. The clinical and parasitological response in children with falciparum malaria to various antimalarials was discussed.