Malaria and splenomegaly a therapeutic trial in eastern Sudan

Abstract EN

In a prospective study, 80 patients with ages ranging from 10 to more than 40 years, were selected from patients seen in the outpatient clinic in Kassala Teaching Hospital.

Fifty-five were males and 25 were females.

All had gross splenomegaly (spleen down to the right iliac fossa).

They lived in Kassala Town (Eastern Sudan), which is holo-endemic for malaria.

They were chosen for a therapeutic trial for splenomegaly (thought to be tropical splenomegaly syndrome (TSS).

The drug selected was chloroquine 150 mg tablets instead of the classical treatment of proguanil 100 mg per day for a long time.

The patients were divided into three groups: A (26 patients), B (25) and C (29).

Group A received 2 tablets of chloroquine daily for 3 months.

Group B received 2 tablets of chloroquine every other day for 6 months.

Group C was treated by 2 tablets of chloroquine twice weekly for 6 months.

Iron and folate supplements were given to all patients for the whole period of treatment.

The mean haemoglobin concentration for all patients at the beginning of the study was 5.0g/dl and the mean white blood count was 2800 cmm (latter parameter was performed to exclude leukaemia).

The result of group A treatment was the complete disappearance of splenomegaly in all patients completely and haemoglobin concentration increased significantly from 5g/dl to 7.5g/dl (0.05).

In group B, the average reduction of spleens was 3 cm and the haemoglobin concentration increased from 5.0g/dl to 5.4g/dl also (P < 0.05 significant).

As for group C, there was neither significant reduction in the size of the spleen nor increase in the haemoglobin concentration.

So it was recommended that 2 tablets of chloroquine daily for 3 month should be the treatment of choice for TSS, plus folic acid and iron supplements.