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Malaria prophylaxis with proguanil in children living in a malaria-endemic area

N Limsomwong1, L W Pang, P Singharaj

  • 1U.S. Army Medical Component, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand.

The American Journal of Tropical Medicine and Hygiene
|March 1, 1988
PubMed

Insights

Daily proguanil and weekly chloroquine showed similar efficacy for malaria prevention in children. Proguanil had more vivax malaria failures, but both treatments were well-tolerated.

Area of Science:

  • Tropical Medicine
  • Infectious Diseases
  • Pharmacology

Background:

  • Malaria remains a significant public health concern in endemic regions.
  • Effective malaria prophylaxis is crucial for protecting vulnerable populations, especially children.
  • Evaluating different antimalarial drug regimens is essential for optimizing prevention strategies.

Purpose of the Study:

  • To compare the efficacy and safety of daily proguanil versus weekly chloroquine for malaria prophylaxis in children.
  • To assess the prophylactic effects against Plasmodium falciparum and Plasmodium vivax malaria.
  • To determine the incidence of malaria infections and treatment-related side effects in both groups.

Main Methods:

  • A randomized controlled trial involving 170 children aged 5-10 years in a malaria-endemic area.
  • Children were matched and randomly assigned to receive either daily proguanil or weekly chloroquine.
  • Weekly malaria smears and monitoring for side effects were conducted throughout the study period.

Main Results:

  • No statistically significant difference in Plasmodium falciparum malaria prophylaxis between daily proguanil and weekly chloroquine.
  • Proguanil showed potential causal prophylactic effects against Plasmodium falciparum.
  • Significantly higher rates of Plasmodium vivax prophylactic failures were observed in the proguanil group (P < 0.01).
  • Adverse events were infrequent, mild, and comparable between the two treatment groups.

Conclusions:

  • Both daily proguanil and weekly chloroquine demonstrate comparable efficacy for Plasmodium falciparum malaria prophylaxis.
  • Daily proguanil may offer some causal prophylactic benefit against Plasmodium falciparum.
  • Weekly chloroquine appears more effective in preventing Plasmodium vivax malaria breakthrough infections.
  • Both regimens are generally well-tolerated in pediatric populations.

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