A randomized, parallel-group study in Mumbai (Bombay), comparing chloroquine with chloroquine plus sulfadoxine-pyrimethamine in the treatment of adults with acute, uncomplicated, Plasmodium falciparum malaria

A major problem in the control of malaria is the development of resistance, of the parasites to the existing drugs and of the vectors to insecticides. With few new drugs in the pipeline, in an era of declining resources, it i s imperative to make judicious use of the existing antimalarials. In the ci ty of Mumbai, resistance exists to chloroquine (CQ) and to sulfadoxine-pyri methamine (SP). Use of a combination of CQ with SP would theoretically slow down the development of resistance to each of the drugs and increase their useful lives. The effectiveness of this combination in the treatment of ad ults from Mumbai, who had acute, uncomplicated Plasmodium falciparum malari a, was compared with that of CQ alone. The combination was found to be sign ificantly more effective, in terms of 28- or 42-day cure rates, and to be m ore cost-effective.