Home treatment of febrile children with antimalaria drugs in Togo

In Togo, the principal strategy for preventing death from malaria in children is prompt treatment of fever with antimalaria drugs. A household survey was conducted in a rural area of south-central Togo in which information was collected from mothers on the treatment received by 507 children under 5 years of age who, according to their mothers, had recently had fever. Altogether, 20 percent of the children (95 percent confidence interval (CI):15-25 percent) were seen at the health centre during their illness, while 83 percent (95 percent CI:76-90 percent) were treated at home with an antimalarial drug. Of the children in the latter group, 97 percent received the drug on the first day of fever. In contrast, only 17 percent of children who attended a health centre were seen on the first day of their fever. Chloroquine, usually obtained from a street or market vendor, was used for 94 percent of the treatments given at home. Based on children's weights and treatment histories provided by their mothers, the median total dosage of chloroquine given at home was 12.8 mg per kg body weight -more than that recommended and known to be fully effective in Togo at the time of the survey (10 mg per kg) and less than the total dosage recommended at present (25 mg per kg). The dosage administered was considered to be inadequate for ...(AU)

Sensitivity of Plasmodium falciparum to chloroquine and sulfadoxine/pyrimethamine in Negerian children

The in vivo sensitivity of Plasmodium falciparum to chloroquine and sulfadoxine/pyrimethamine was evaluated in children under 5 years of age in two areas of southern Nigeria in 1987. A modification of the WHO Standard Field and Extended Tests (in vivo) was used, with follow-up on days, 2, 3, 7, and 14 after treatment with 25 mg chloroquine per kg body weight given over 3 days, or with standard doses of sulfadoxine/pyrimethamine. Clinical and parasitological evaluations were performed

At Igbo Ora, in Oyo State, where by day 7 chloroquine was clinically successful in 94.4 per cent of 36 children and sulfadoxine/pyrimethamine in 91.7 per cent of 36 children, there were no parasitological failures in either treatment group. Fever regressed significantly more rapidly with chloroquine than with sulfadoxine/pyrimethamine. At Oban, in Cross River State, initial parasite densities decreased markedly with the chloroquine regimen but 63.6 per cent of 44 children were parasitological failures on day 3, 7, or 14; and all of the 26 children who failed parasitologically and completed follow-up were successfully treated with sulfadoxine/pyrimethamine. By day 7, clinical success was demonstrated for 77.3 per cent of the children treated with chloroquine. The in vitro sensitivity to chloroquine, quinine, and mefloquine at Igbo Ora ...(AU)