The Present Status of Chloroquine in the DrugTreatment of Malaria

Abstract

Chloroquine is the drug of first choice in the suppression of an acute attack of malaria, being more effective and less toxic than any of its predecessors. For prophylaxis, pyrimethamine, proguanil or cycloguanil is appropriate where strains of malaria parasites are sensitive to these; any of them may be combined with sulphadiazine or dapsone for better prophylaxis. Primaquine remains the only drug clinically useful in eliminating the tissue stages of relapsing malaria. The development of toxic eye lesions, particularly on the retina was unveiled when high dose s of chloroquine for prolonged periods were used for non-malaria condition s like rheumatoid arthritis a n d discoid lupus erythematosus. From south - east Asia and South America had come many reports of the development of chloroquine-resistanc e by strains of Plasmodium falciparum. Resistance to chloroquine has not been a feature of falciparum malaria in West Africa yet. In places where chloroquine-resistance had been established, various combination s of chloroquine with quinine, pyrimethamine , sulphormethoxine or dapsone were found effective. Malaria prophylaxis with chloroquine is not advisable in view of the possibility of ocular toxicity on prolonged use and the danger of inducing chloroquine-resistance in malaria parasites. West Africa should be on their guard against chloroquine-resistant P. falciparum.