Clindamycin for the treatment of falciparum malaria in Sudan

Clindamycin, 5 mg/kg twice a day for 5 days, was used to treat falciparum malaria after clinical and parasitological diagnosis at a health station in Faki Hashim, a suburb of Khartoum, Sudan. Twenty out of twenty-six patients enrolled completed the study. Giemsa-stained thick blood films were negative for asexual parasites by day 7 in 17 patients and by day 8 in the remaining 3. All were examined on days 14 or 28; 2 who had initially been cleared by day 6 had asymptomatic low density asexual parasitemia on day 14, which disappeared without treatment by day 28, and 2 others initially cleared by day 5 were similarly positive at day 28. Reinfection in these patients cannot be ruled out. Of the 6 patients withdrawn from the study, 2 took chloroquine independently, 1 developed vomiting, 1 developed diarrhea, 1 acquired a circumoral maculopapular rash, and 1 had an increasing parasitemia on day 3 and was switched to chloroquine. Generally, the treatment was without toxicity and was well received. Clindamycin proved satisfactory for the treatment of simple cases of falciparum malaria in the field in Africa.