Daily Primaquine is Effective for Prophylaxis against Falciparum Malaria inKenya: Comparison with Mefloquine, Doxycycline, and Chloroquine Plus Proguanil

摘要

Primaquine was tested as a prophylactic drug against PIasmodium falciparum in aregion in western Kenya in which malaria is holoendemic. Children 9-14 years old were randomized to receive regimens of daily primaquine, daily doxycycline, daily proguanil plus weekly chioroquine, daily vitamin plus weekly mefloquine, or daily vitamin alone. Primaquine, doxycycline, and mefloquine were equally effective in preventing both symptomatic and asymptomatic malarial infections. Chloroquine plus proguanil was the least effcctive regimen. There was no toxicity from daily primaquine during the II weeks of the study. Findings show that primaquine can be successfully uscd as a causal prophylactic regimen against falciparum malaria in western Kenya; chloroquine plus proguanil was not as efficacious as the three other preventive regimens; most Kenyan children receiving standard doses of melloquine and doxycycline had lower than expected serum trough drug levels; and some volunteers with adequate mefloquine or doxycycline levels at trough developed asymptomatic parasitemias and clinical malaria.