DAILY PRIMAQUINE IS EFFECTIVE FOR PROPHYLAXIS AGAINST FALCIPARUM-MALARIA IN KENYA - COMPARISON WITH MEFLOQUINE, DOXYCYCLINE, AND CHLOROQUINE PLUS PROGUANIL

Primaquine was tested as a prophylactic drug against Plasmodium falcip arum in a region in western Kenya in which malaria is holoendemic. Chi ldren 9-14 years old were randomized to receive regimens of daily prim aquine, daily doxycycline, daily proguanil plus weekly chloroquine, da ily vitamin plus weekly mefloquine, or daily vitamin alone, Primaquine , doxycycline, and mefloquine were equally effective in preventing bot h symptomatic and asymptomatic malarial infections. Chloroquine plus p roguanil was the least effective regimen, There was no toxicity from d aily primaquine during the 11 weeks of the study, Findings show that p rimaquine can be successfully used as a causal prophylactic regimen ag ainst falciparum malaria in western Kenya; chloroquine plus proguanil was not as efficacious as the three other preventive regimens; most Ke nyan children receiving standard doses of mefloquine and doxycycline h ad lower than expected serum trough drug levels; and some volunteers w ith adequate mefloquine or doxycycline levels at trough developed asym ptomatic parasitemias and clinical malaria.