Recrudescence of falciparum malaria following treatment with halofantrine.

In 1991, some 90 countries or areas where 42% of the world's population resided were considered malarious and estimation of malaria mortality worldwide per year was 1.5 to 3 million'). The Ministry of Justice reported that the total number of Japanese who went abroad was as many as 11,790, 699 and the number of foreigners who entered Japan for the first time was 3,251,753 in 1992. Consequently the reported annual number of imported malaria cases increased to not less than 1002), and therefore malaria is no longer considered a very rare infectious disease in Japan. Indeed, there have been a number of severe cases of malaria because of the delay in the onset of effective treatment3'4). Malaria should first be presumed if a patient complains of high fever after a visit to a tropical country. Proper diagnosis and treatment should be instituted immediately. One of the antimalarials which has been highlighted for its effectiveness is halofantrine. This drug has been used for treatment of human malaria since 1984, and to date, clinical studies have involved more than 2500 patients in 30 countries5). Several patients successfully treated with halofantrine without any treatment failure have also been documented in Japan6)-10). However, in this paper, we discuss the first case of recrudescence of falciparum malaria following treatment with halofantrine.