Chemotherapeutic Control Trial of Plasmo- Dium Falciparum with a Combination of Chloroquine and Primaquine on Selec- Tive Age Group in a Coastal Village of North Sumatra, Indonesia

Active case detection and treatment of malaria in a selective age group of children up to the age of fifteen was carried out to control malaria in a coastal village in North Sumatra, Indonesia from September 1983 to July 1984. A combination of chloroquine for three days with primaquine for three or five days was more effective than only chloroquine for three days. The spleen rate, the parasite rate of P. falciparum, the parasite formula of P. falciparum and the parasite density index were reduced by this activity. The parasite rate and the parasite formula of P. falciparum did not rise up in July 1984 (12.3% and 14.3%, respectively) without any vector control activities, although the parasite rate used to rise up to 27-61% and the parasite formula of P. falciparum was 50-86% in July to September every year (1980-1983). Most of the patients in July 1984 were considered to be recurrent or inadequately treated cases of P. vivax. Furthermore the density of P. falciparum gametocyte in pre-school children was higher than that in school children. We should pay a special attention to pre-school children to interrupt malaria transmission aiming at the gametocyte stage. Detection of glucose-6phosphate dehydrogenase (G6PD) deficiency was done at the same time and malaria patient with G6PD deficiency was not given primaquine. INTRODUCTION Malaria control programme in these days is facing to some difficulties: drug resistant Plasmodium fakiparum, insecticide resistant anopheline mosquitoes, behavioral change of the vectors, financial problem and so on. In North Sumatra, Indonesia, there is a report of Anopheles sundaicus, which is a vector in a coastal village, Perupuk, having exophilic character and few indoor resting behavior (Ikemoto, 1982). The residual house spraying with DDT could not reduce the parasite rate in Perupuk village, which was explained by the exophilic character and the lack of indoor resting behavior, although A. sundaicus in this village was still sensitive to DDT (Karoji, 1982). As malaria control by residual house spraying for adult mosquito is not 1 Department of Parasitology, Okayama University Medical School, 2-5-1, Shikata-cho, Okayama City, 700, Japan 2 North Sumatra Provincial Health Service, Medan, Indonesia This work was supported by Japan International Cooperation Agency (JICA) as the project for the promotion of health in North Sumatra, which was an international cooperation project between the Republic of Indonesia and Japan.