Comparative Trial of Artesunate and Halofantrine in the Treatment of uncomplicated Malaria in Children at a General Hospital in Enugu

Abstract

Objective: To compare the efficacy of oral artesunate with that of halofantrine in the treatment of uncomplicated malaria in children.

Design: Arandomized comparative clinical trial whereby children who met the inclusion criteria were recruited and randomized for treatment with the trial drugs.

Subjects and Method: Patients aged two years to 11 years who lived within Enugu metropolis and had fever of > 37.5°C associated with Plasmodium falciparu parasitaemia, and without any other severe illness, were recruited. They were randomized to receive either oral artesunate or oral halofantrine at standard doses. Theywere then followed up for 14 days, during which period, the effects of the drugs were evaluated.

Results: Fifty-six children were enrolled, but 40 completed the study. Cure rate by day 7 was 71.4 percent for children on artesunate and 47.4 percent in the halofantrine group. Recrudescence rates in the artesunate groups were 0 percent and 4.8 percent respectively. Fever clearance time was two days for both halofantrine and artesunate. Haematocrit gains by day 7 were 3.64 percent and 3.67 percent in the halofantrine and artesunate groups, respectively. No serious adverse effects, were recorded in both groups.

Conclusions: There was a high rate of treatment failure with both oral artesunate and halofantrine, although artesunate showed an apparently better efficacy. Both drugs were well tolerated and safe.

Keywords: Malaria, Artesunate, Halofantrine, Efficacy, Children.