Abstract
Fifty subjects with acute uncomplicated falciparum malaria were treated orally with a new micronized formulation of halofantrine. The dose given corresponded to one-half the normal dose for the standard formulation. Parasitemia cleared in all subjects within 78 h. There was recrudescence of falciparum malaria in seven subjects after day 14. The mean +/- standard deviation clearance times of parasitemia and fever were 49.0 +/- 14.2 and 24.3 +/- 13.2 h, respectively. Other clinical symptoms related to malaria cleared within the first 3 days. Pruritus occurred in two subjects, back pain occurred in one subject, and diarrhea occurred in one subject; all of these symptoms were mild. Hematological and biochemical indices were not adversely affected by treatment except in five subjects in whom minor and transitory increases in aspartate aminotransferase and alanine aminotransferase were observed. Micronized halofantrine appears to be a safe, well-tolerated, and effective treatment for acute falciparum malaria in semiimmune patients.
Highlights
The spread of chloroquine-resistant Plasmodium falciparum to most countries in Africa has prompted the development of alternative drugs for the treatment of malaria
Chloroquine-resistant P. falciparum is commonly encountered in most countries in Africa
Previous studies have shown that halofantrine is an effective drug for the treatment of acute falciparum malaria in areas of chloroquine resistance in Africa [17, 19, 20]
Summary
The spread of chloroquine-resistant Plasmodium falciparum to most countries in Africa has prompted the development of alternative drugs for the treatment of malaria. Halofantrine has been used since 1988 in France and some West and Central African countries and was demonstrated to be effective in treating resistant falciparum malaria [5, 10, 17]. A major drawback of halofantrine is its poor and variable absorption and bioavailability between subjects; these have been responsible for a number of treatment failures [3, 11, 12, 15, 18]. Attempts to develop a new micronized formula have recently been made. The goal of the current study was to assess the efficacy and safety of this improved, micronized formulation in an area of intense and continuous malaria transmission in Cameroon
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