Relapses that may occur with long standard treatment of vivax malaria might be in
part due to an incomplete patient compliance. Therefore, the employment of short
treatment schemes leading to a better patient compliance, and the same time having
efficacy, tolerance and minimal or none adverse reactions is a matter of serious
concern. In order to attain this objective, between july, 1994 to june, 1995, an open,
comparative, prospective and randomized study was made in the attendance
outpatient unit of Malaria Program of Evandro Chagas Institute, in Belem, Para
State. Just patients aged up 12 years, from both sexes, which stayed in Belem
during all the period control were enrolled. All patients were from Amazon Region,
being the great majority of them from Para (85.8%). Autochthonous cases from the
metropolitan area of Belem represented 39.2% of the sample. In this study, 120
patients were divided into 3 groups of 40 patients according to the following
therapeutic schemes : Scheme I - chloroquine phosphate tablets with 150 mg of
base substance in a total dose of 25 mg / kg / day for 3 days, that is, 10 mg / kg / day
in the first day, 7.5 mg / kg / day in the second and third day, plus primaquine
phosphate tablets with 15 mg of base substance in a dose of 0.25 mg / kg / day for
14 days. Scheme II - chloroquine phosphate tablets with 150 mg of base substance,
10 mg / kg in a single dose plus primaquine phosphate tablets with 15 mg of base
substance in a dose of 0.50 mg / kg / day for 7 days. Scheme III - chloroquine
phosphate tablets with 150 mg of base substance, 10 mg / kg in a single dose plus
primaquine phosphate tablets with 15 mg of base substance in a dose of 0.50 mg /
kg/ day for 5 days. Drugs were administered orally, under medical supervision to all
outpatients.Clinical diagnosis was based upon history, epidemiology and physical
examination of patients, while the laboratory finding of the hematozoa plasmodium in
a thick blood film established the definitive malaria diagnosis. All 3 therapeutic
schemes were effective, with a cure rate up to 80%. In the II therapeutic scheme,
relapses were not observed. The disappearance of malarial symptoms occurred until
96 hours of treatment, while the assexual parasitaemie clearance occurred until 72
hours, considering all 3 therapeutic schemes. When present, adverse reactions were
observed in a short period of time. Even in the cases of primaquine in double dose,
there were no toxicity.
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