Publication Detail

The publication detail shows the title, authors (with indicators showing other profiled authors), information on the publishing organization, abstract and a link to the article in PubMed. This abstract is what is used to create the fingerprint of the publication. If any grants are referenced by the publication, they will be listed here as well.

Return of chloroquine antimalarial efficacy in Malawi.

Miriam K Laufer; Phillip C Thesing; Nicole D Eddington; Rhoda Masonga; Fraction K Dzinjalamala; Shannon L Takala; Terrie E Taylor; Christopher V Plowe (Profiled Authors: Miriam K Laufer; Christopher Plowe; Shannon Takala Harrison)

University of Maryland School of Medicine, Baltimore, MD 21201, USA.
The New England journal of medicine 2006;355(19):1959-66.

BACKGROUND: In 1993, Malawi became the first country in Africa to replace chloroquine with the combination of sulfadoxine and pyrimethamine for the treatment of malaria. At that time, the clinical efficacy of chloroquine was less than 50%. The molecular marker of chloroquine-resistant falciparum malaria subsequently declined in prevalence and was undetectable by 2001, suggesting that chloroquine might once again be effective in Malawi. METHODS: We conducted a randomized clinical trial involving 210 children with uncomplicated Plasmodium falciparum malaria in Blantyre, Malawi. The children were treated with either chloroquine or sulfadoxine\#8211;pyrimethamine and followed for 28 days to assess the antimalarial efficacy of the drug. RESULTS: In analyses conducted according to the study protocol, treatment failure occurred in 1 of 80 participants assigned to chloroquine, as compared with 71 of 87 participants assigned to sulfadoxine\#8211;pyrimethamine. The cumulative efficacy of chloroquine was 99% (95% confidence interval [CI], 93 to 100), and the efficacy of sulfadoxine\#8211;pyrimethamine was 21% (95% CI, 13 to 30). Among children treated with chloroquine, the mean time to parasite clearance was 2.6 days (95% CI, 2.5 to 2.8) and the mean time to the resolution of fever was 10.3 hours (95% CI, 8.1 to 12.6). No unexpected adverse events related to the study drugs occurred. CONCLUSIONS: Chloroquine is again an efficacious treatment for malaria, 12 years after it was withdrawn from use in Malawi. (ClinicalTrials.gov number, NCT00125489 [ClinicalTrials.gov].).

3 Originating Grant

• 1.

  Laufer, Miriam K

  Molecular epidemiology of drug resistant malaria

  1 July 2004 - 31 March 2009

  NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES

• 2.

  Plowe, Christopher V

  DRUG-RESISTANT MALARIA IN MALAWI

  1 September 1999 - 31 May 2004

  NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES

• 3.

  Plowe, Christopher V

  Clinical Trial of Chloroquine Combinations in Malawi

  1 September 1999 - 30 September 2010

  NATIONAL INSTITUTE OF ALLERGY AND INFECTIOUS DISEASES

Scientific Context

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