Efficacy of dapsone with pyrimethamine (Maloprim) for malaria prophylaxis in Maputo, Mozambique

Abstract

In a randomized controlled study of malaria prophylaxis, dapsone-pyrimethamine at a weekly dosage of dapsone 50-100 mg with pyrimethamine 6.25-12.5 mg or placebo was administered to 166 school children for 17 weeks. Fortnightly parasitological controls revealed 28 infections in the placebo group and none in the dapsone-pyrimethamine group. It is concluded that weekly dapsone-pyrimethamine is effective for the prophylaxis of falciparum malaria in Mozambique.

PIP: A randomized, blinded comparison of malaria prophylaxis with dapsone-pyrimethamine vs. placebo was conducted in 166 schoolchildren from Maputo, Mozambique, from February to June 1989. The children, aged 7-12, received 1 tablet of Maloprim (Wellcome, 100 mg dapsone and 12.5 mg pyrimethamine), or half a tablet if they weighed 30 kg. After being tested for malaria parasites, children were started on Maloprim the next day, or if infected, after treatment with sulfadoxine-primethamine for 2 weeks. Drugs were administered weekly, and capillary blood was checked by-weekly. There were 28 Plasmodium falciparum infections among children taking placebos, and none in those given prophylaxis. Hematocrits were unchanged. This is the 1st study of dapsone-pyrimethamine for prophylaxis in a chloroquine-resistant malaria area. Since use of this agent on a massive scale could result in resistance, it is recommended that its use be restricted to target groups such as primigravidas or to narrow time periods such as early stage of epidemics.