A comparative study of the efficacy of halofantrine and chloroquine in uncomplicated malaria at the Kenyatta National Hospital
Abstract
The aims of this study were to determine and compare the
efficacy of chloroquine and halofantrine in uncomplicated
malaria; and to compare the outcome of treatment in both
groups. A total of 98 patients, 49 per group were recruited
into the study. All patients recruited were positive, on
blood smear, for P. falciQarum with a mean initial
parasiteamia of 1.5 ± 1.49% and 1.45% ± 1.28% for
chloroquine and halofantrine respectively. A male to female
ratio of 1.45 to 1.0 was coincidentally found for both the
chloroquine and halofantrine groups. The mean duration of
illness was 4.7 days for the chloroquine group and 4.5 days
for the halofantrine group.
A mean initial temperature of 37.83 ± 0.98°C and
38.32 ± 0.97°C for chloroquine and halofantrine respectively
was observed. 85.7% of the chloroquine treated
travelled outside Nairobi province within the past one
month. 81.6% of the halofantrine group similarly had
travelled outside Nairobi province within the past one
month.
The mean age in the chloroquine group was 26.4 ± 9.9 years
while that in the halofantrine group was 31.7 ± 13.4 years.
Clinical features observed at presentation for the
chloroquine group were: fever (98%), chills (98%), joint
pains (98%), dizziness (89.8%), malaise (89.8%), headache
(89.8%), backache (75.5%), nausea (71.4%), vomiting (53.1%),
palpitations (53.1%), cough (51.0%) and diarrhoea (46.9%).
Clinical features at presentation for the halofantrine
group were: chills (98%), fever (91.8%), joint pains (98%),
dizziness (91.8%), malaise(89.8%) backache (85.7%), headache
(89.8%), nausea (81.6%), vomiting (59.2%), palpitations
(53.1%), cough (42.9%) and diarrhoea (34.7%).
Parasite clearance time for the chloroquine group was
48.12 ± 26.64 hours as opposed to the significantly shorter
parasite clearance time of 37.82 ± 15.91 hours for the
halofantrine group (2-tail prob.=0.023). Temperature
dissolution time for the chloroquine group was 40.25 ± 24.52
hours as opposed to the shorter temperature dissolution time
of 36.52 ± 17.29 hours for the halofantrine group (2 tail)
prob.=0.392) .
Side effects were uncommon in both groups with pruritus
being the most common in each group occurring in 26.5% and
10.2% of the chloroquine and halofantrine groups
respectively. Other side effects infrequently noted were
headache, cough, diarrhoea, palpitations and rash in a
single patient.
After a 28 day followup, recrudescence was observeo in
33.3% and 2.94% of the chloroquine and halofantrine~grq~ps
respectively. Unfortunately 24.5% and 22.4% of the
chloroquine and halofantrine group were lost to follow up.
H. P.L.C. estimates of whole blood halofantrine and
desbutylhalofantrine revealed a range of 84.2ng/ml - 728.0
ng/ml and 70.0ng/ml - 555.7ng/ml respectively in 12 patients
who showed no recrudescence and a halofantrine range of
Ong/ml - 10ng/ml and a desbutyl halofantrine range of
Ong/ml 14.5ng/ml, in the one patient who had recrudescence
in the halofantrine group.
Citation
Degree of Master of Medicine (Internal Medicine) in the University of NairobiPublisher
University of Nairobi Department of Medicine
Description
A dissertation submitted in partial fulfillment
for the Degree of Master of Medicine (Internal
Medicine) in the University of Nairobi