Ketotifen in treatment of uncomplicated falciparum malaria

OBJECTIVE: The present in vivo study evaluates the potential use of ketotifen, a tricyclic antihistaminic drug, in treatment of Sudanese patients with uncomplicated Plasmodium falciparum malaria (19-38 years).

METHODS: Four groups of patients (each has 15) were randomly selected and treated by chloroquine (25mg/kg wt) in comparison with regimen combinations of ketotifen (0.13mg/kg body wt) with chloroquine, ketotifen with Fansidar (33.3mg/kg body wt) and ketotifen with both chloroquine and Fansidar.

RESULTS: Prior to treatment all patients had a parasite density that varied from 1x103-3.46x104/mL blood. On day 2, the highest level of parasitaemia was recorded in patients treated with chloroquine only. Other patients had a significantly lower parasitaemia (P<0.05) with an average range of 111-243 parasites/300 leucocytes. On day 3 no parasites were detected in groups treated by ketotifen and Fansidar or by ketotifen in combination with Fansidar and chloroquine. The mean time of parasite clearance was minimum (<32 h) amongst patients that had choloroquine administered with ketotifen alone or with both Fansidar and ketotifen. The cumulative percentage of cases with recrudescence was >39% in groups that had the chloroquine regimen alone or the combination of chloroquine with ketotifen. A single case of recrudescence was also diagnosed on day 28 in the group treated with ketotifen plus fansidar but no recrudescence occurred in the group treated with the combination of the three drugs.

CONCLUSION: This study indicates the possible role of ketotifen in treatment for falciparum malaria particularly when administered in combination with chloroquine and fansidar.