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Chloroquine Returns as Anti-Malarial Drug in Malawi

After a 13-year withdrawal, chloroquine is shown to be more effective than its replacement

WEDNESDAY, Nov. 8 (HealthDay News) -- The anti-malarial drug chloroquine, withdrawn by Malawi in 1993 because of declining efficacy, may once again be an effective treatment, according to study findings published in the Nov. 9 issue of the New England Journal of Medicine.

Miriam K. Laufer, M.D., of the University of Maryland School of Medicine in Baltimore, and colleagues randomly assigned 210 Malawi children with uncomplicated Plasmodium falciparum malaria to receive either chloroquine or the preferred treatment -- sulfadoxine-pyrimethamine -- and followed them for 28 days.

The researchers found that only one of the 80 children in the cholorquine group experienced treatment failure, compared with 71 of 87 children in the sulfadoxine-pyrimethamine group, resulting in a cumulative efficacy of 99 percent for chloroquine and 21 percent for sulfadoxine-pyrimethamine.

"How good is this news from a public health perspective?" asks the author of an accompanying editorial. "Can we now abandon these new, relatively expensive anti-malarial agents and return to our old and trusted friend chloroquine? Laufer and her colleagues wisely counsel against doing so. Malawi is surrounded by a sea of chloroquine resistance…Chloroquine could re-enter the increasingly promising queue of new candidate anti-malarial agents -- but it needs to leave before it can come back."

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