Double-blind, randomized, placebo-controlled assessment of chloroquine/primaquine prophylaxis for malaria in nonimmune Colombian soldiers

To improve upon the efficacy of primaquine prophylaxis for malaria (94%, Pl asmodium falciparum malaria; 85%, Plasmodium vivax malaria), we administere d chloroquine (300 mg weekly) in combination with primaquine (30 mg daily) to nonimmune Colombian soldiers during 16 weeks of patrol in a region of en demicity and for a further 1 week in base camp. The occurrence of symptomat ic parasitemia was determined during those 17 weeks and during a further 3 weeks in base camp. The protective efficacy for the chloroquine/primaquine treatment group of 100 subjects, compared with that for the placebo treatme nt group of 51 subjects, was 88% (95% confidence interval [CI], 76-94) agai nst all types of malaria, 89% (95% CI, 61-97) against P. falciparum malaria , and 88% (95% CI, 58-93) against P. vivax malaria. Two chloroquine/primaqu ine recipients had severe gastrointestinal distress. Comparison of these da ta with data from a previous study indicates that the addition of chloroqui ne did not increase the prophylactic efficacy of primaquine.