HALOFANTRINE AND PRIMAQUINE FOR RADICAL CURE OF MALARIA IN IRIAN-JAYA, INDONESIA

The combination of halofantrine and primaquine therapies was evaluated as a regimen for achieving radical cure of falciparum or vivax malari a in Irian Jaya, Indonesia, and compared with combined chloroquine and primaquine therapies. The patients who volunteered for the study [adu lt, male, Indonesian immigrants with no previous exposure to endemic m alaria, normal glucose-6-phosphate dehydrogenase (G6PD) activity, unco mplicated malaria illness, no prior use of antimalarials, and parasita emias of 0.001%-1.0%] were randomized to receive either halofantrine ( 24 mg base/kg bodyweight, in three equal doses over 12 h) or chloroqui ne (25 mg base/kg bodyweight over 48 h, in doses of 10, 10 and 5 mg ba se/kg at 24-h intervals). Each patient also received concurrent daily primaquine (0.5 mg base/kg bodyweight) for 14 days followed by the sam e dose on alternate days to day 28. A recurrent parasitaemia during th e 28 days of follow-up constituted drug failure. Of the 40 cases of fa lciparum malaria and 26 cases of vivax malaria treated with halofantri ne-primaquine, none had a recurrent parasitaemia (100% efficacy). In c ontrast, 20 of 30 patients with falciparum malaria and three of 27 wit h vivax malaria had recurrent parasitaemias after chloroquine-primaqui ne, giving efficacies of 33% and 89%, respectively. Halofantrine-prima quine was significantly more effective than chloroquine-primaquine aga inst falciparum malaria (P< 0.001) but was similarly efficacious again st vivax malaria (P = 0.23). On average, fever associated with falcipa rum or vivax malaria cleared 17 h faster with halofantrine-primaquine (P<0.01) although there were no significant differences (P>0.4) in par asite-clearance times between the two regimens. The halofantrine-prima quine regimen was also associated with a more rapid and significant de cline in malaria-related physical complaints.