In vivo efficacy study of quinine sulphate in the treatment of uncomplicated P. falciparum malaria in patients from Southwestern Cameroon
Achidi, E.A.; Ajua, A.; Kimbi, H.K.; Sinju, C.M.
East African Medical Journal 82(4): 181-185
2005
ISSN/ISBN: 0012-835X PMID: 16122085 Document Number: 594554
Objective: To evaluate clinical, parasitological, and haematological responses to quinine sulfate therapy in patients with uncomplicated malaria using the 14-day WHO protocol. Design: A longitudinal study conducted during the peak malaria transmission period (May-August) in 2002. Setting: The Buea Provincial hospital annex located in southwestern Cameroon. Subjects: The study participants consisted of 73 children (>=8 months) and adults (<=50 years) with acute malaria attending the outpatient division of health institutions within Fako Division. Results: Quinine sulfate failure was found in 42% of the patients, and classified as RI (10%; initial clearance followed by recrudescence, before and after day 7) and RII (32%; reduction of parasitaemia to <25% of initial parasitaemia, but no clearance) types. Clinically, the overall success rate was 94.2%, while therapeutic failures were observed in four patients (5.8%). Also, 27.4% and 17.4% of the patients were anaemic at enrolment and day 14, respectively. The mean packed cell volume (PCV) levels of the patients increased during the follow-up period, except on day 3 when mean PCV levels dropped. The difference in the mean PCV levels during the follow-up was significant (F=60.29; P=0.0001). Conclusion: The relatively high resistance to quinine sulfate observed in this study suggests the need to monitor the spread of resistance to this drug in the study region.