The efficacy of
chloroquine plus
chlorpheniramine, a
histamine H receptor antagonist, which reverses
chloroquine 1 insensitivity in Plasmodium falciparum in vitro and in vivo , was evaluated in 30 pregnant women with recrudescent
chloroquine-resistant
Plasmodium falciparum malaria. All patients had at least one or more treatment failures with one or more courses of
chloroquine or
pyrimethamine-sulphadoxine. There was a prompt response to treatment with parasitaemia and
fever clearing in all patients within 48 and 96 hours respectively of commencement of
therapy with the combination. The cure rate on day 14 was 77%. Parasitaemia recurred in seven patients after day 14 and was successfully treated with oral
mefloquine. The combination was well tolerated;
pruritus and drowsiness were the only noticeable adverse effects. The progress of pregnancy and its outcome were not adversely affected by treatment with the combination. When fully developed, the combination of
chloroquine plus
chlorpheniramine may be an alternative in the treatment of
chloroquine-resistant
malaria during pregnancy in Nigerian women.