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Date of this Version



Annals of Tropical Medicine & Parasitology, Vol. 91, No. 1, 7-16 (1997)


U.S. Government Work


The combination of halofantrine and primaquine therapies was evaluated as a regimen for achieving radical cure of falciparum or vivax malaria in Irian Jaya, Indonesia, and compared with combined chloroquine and primaquine therapies. The patients who volunteered for the study {adult, male, Indonesian immigrants with no previous exposure to endemic malaria, normal glucose-6-phosphate dehydrogenase (G6PD) activity, uncomplicated malaria illness, no prior use of antimalarials, and parasitaemia s of 0.001%-1.0%} were randomized to receive either halofantrine (24 mg base/kg bodyweight, in three equal doses over 12 h) or chloroquine (25 mg base/kg bodyweight over 48 h, in doses of 10, 10 and 5 mg base/kg at 24-h intervals). Each patient also received concurrent daily primaquine (0.5 mg base/kg bodyweight) for 14 days followed by the same dose on alternate days to day 28. A recurrent parasitaemia during the 28 days of follow-up constituted drug failure. Of the 40 cases of falciparum malaria and 26 cases of vivax malaria treated with halofantrine-primaquine, none had a recurrent parasitaemia (100% efficacy). In contrast, 20 of 30 patients with falciparum malaria and three of 27 with vivax malaria had a recurrent parasitaemia after chloroquine-prim aquine, giving efficacies of 33% and 89%, respectively. Halofantrine-primaquine was significantly more effective than chloroquine-primaquine against falciparum malaria (P<0.001) but was similarly efficacious again st vivax malaria (P=0.23). On average, fever associated with falciparum or vivax malaria cleared 17 h faster with halofantrine-prim aquine (P<0.01) although there were no significant differences (P<0.4) in parasite-clearance times between the two regimens. The halofantrine-prim aquine regimen was also associated with a more rapid and significant declin e in malaria-related physical complaints.