RESPONSE OF FALCIPARUM-MALARIA TO CHROLOQUINE AND 3 2ND-LINE ANTIMALARIAL-DRUGS IN A KENYAN COASTAL SCHOOL-AGE POPULATION

Ambulatory rural school children in the Mombasa area with P. falciparu m parasitaemia were examined and randomly assigned to treatment with o ne or three second-line antimalarials-amodiaquine, pyrimethamine/sulph adoxine (P/SD) and pyrimethamine/sulfalene (P/SL). Clinical signs and parasitaemia were followed daily for the first week and on days 14 and 28. WHO Mark II schizont inhibition tests were performed for all the above 3 drugs and chloroquine. The total number of cases was 73. The m ean parasite density was 142.1 +/- 207; 102.7 +/- 166; 82.74 +/- 93 pa rasites per 300 WBC for amodiaquine, P/SD, and P/SL, respectively. In vitro tests showed a chloroquine resistance rate of 60% and no resista nce to all of the second line drugs. Also, all children treated succes sfully cleared their parasitaemia with mean clearance rates of 2.05 +0 .57; 1.86 +/- 0.47; 2.05 +/- 0.50 days for amodiaquine, P/SD and P/SL, respectively. Even though, no difference in the effectiveness between the second line drugs used was found, reinfection rates as depicted b y day 28 parasitaemia differed-amodiaquine 16%; P/SD 0%; and P/SL4.35% . This difference could be attributed to the difference in the pharmac okinetic properties or the drugs.