Reducing the oral quinine-quinidine-cinchonin (Quinimax(R)) treatment of uncomplicated malaria to three days does not increase the recurrence of attacks among children living in a highly endemic area of Senegal

A 3 d shortened course of the quinine-quinidine-cinchonin association Quinimax(R) was compared to the usual 7 d regimen for routinely treating 462 acute uncomplicated Plasmodium falciparum malaria attacks in 72 children under the age of 10 years in Dielmo, a holoendemic village in Senegal. 25 mg/kg Quinimax(R) salt daily, given in 3 equal doses, improved clinical status in 99.6% of the patients receiving the course and in all of those treated for 7 d. Even if the 3 d course did not systematically eliminate parasitaemia, reducing oral Quinimax(R) treatment of uncomplicated malaria from 7 to 3 d did not increase the recurrence of attacks, even among the youngest children. Both the quinine sensitivity of the Senegalese strains of P. falciparum and the partial acquired immunity of the children were probably responsible for the absence of any difference between the courses. Oral Quinimax(R) for 3 d is a possible alternative regimen to chloroquine and sulfadoxine-pyrimethamine for treating uncomplicated malaria in highly endemic areas of Africa where clinical resistance to these drugs exists.