CARDIAC EFFECTS OF HALOFANTRINE IN CHILDREN SUFFERING FROM ACUTE UNCOMPLICATED FALCIPARUM-MALARIA

The cardiac effects of halofantrine were assessed in 42 children with acute symptomatic uncomplicated Plasmodium falciparum malaria by elect rocardiographic (ECG) and clinical monitoring over a period of 14 d. T he children were treated with oral halofantrine 8 mg/kg body weight ev ery 6 h for 3 doses. There was significant prolongation of the P-R int erval (compared with the pre-treatment value) only at 8 h after drug a dministration. However, first degree auriculoventricular (AV) block oc curred in 2 children at 8 h or 8 and 48 h, and second degree AV block in another child at 48 h. There was significant prolongation of the Q- Tc interval at 8, 16, 24, 48 and 72 h after treatment; the proportions of children with Q-Tc interval >0.44 s were also significantly higher at all these times except 72 h. Rhythm disturbance was rare. There wa s no significant ECG change at 168 or 336 h. Despite the ECG abnormali ties, there was no clinical symptom. These findings indicate that, in children, the currently recommended dose of halofantrine for the treat ment of falciparum malaria may produce serious cardiac side effects.