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Haematological safety of long‐term malarial prophylaxis with dapsone‐pyrimethamine
Author(s) -
Cook Ian F.,
Kish Marilyn Y.
Publication year - 1985
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/j.1326-5377.1985.tb122869.x
Subject(s) - dapsone , pyrimethamine , medicine , incidence (geometry) , malaria , regimen , chloroquine , pharmacology , immunology , pediatrics , physics , optics
There are no published haematological data on the long‐term (more than one year) use of dapsone‐pyrimethamine (Maloprim, Folaprim; one tablet a week) for malarial prophylaxis. In a study of 373 male Papua New Guinean soldiers who had used this combination for five years, we found no haematological abnormalities attributable to dapsone‐pyrimethamine. Furthermore, the haematological parameters of these soldiers were not clinically different from those of Papua New Guinean university students who did not ingest antimalarial drugs prophylactically. In a parallel study, 9 of 159 white persons (6 children and 3 adult females) who had used dapsone‐pyrimethamine prophylaxis for more than one year had haematological abnormalities attributable to the drug. Additionally, the mean leucocyte count of children aged 1‐9 years who took dapsone—pyrimethamine was markedly lower — although within the normal range — than that of similarly aged children who received chloroquine for malarial prophylaxis. The appreciable incidence of haematological abnormalities observed in children during malarial prophylaxis with dapsone—pyrimethamine demonstrates the need to select a dose for this group on a weight rather than an age basis and to use a liquid formulation to facilitate the administration of the appropriate dose of this combination. Haematological monitoring of the long‐term use of dapsone‐pyrimethamine is recommended and a suitable monitoring regimen is suggested.