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Clinical Standardization of Pamaquin (Plasmochin) in Mosquito-Induced Vivax Malaria, Chesson Strain

A Preliminary Report¹

Several regimes of pamaquin (plasmochin) were given a therapeutic trial in mosquito-induced vivax malaria (Chesson strain).

The administration of daily doses of 63 milligrams of the base or 140 milligrams of the naphthoate salt, or less, concurrently with quinine for 14 days protected only a few of the subjects against relapse. No protection was afforded when the drugs were given serially. The effect was not appreciably enhanced when pamaquin (31 milligrams of the base a day) was administered concurrently with several other experimental drugs.

The average percentage of total hemoglobin converted to methemoglobin was a useful measure for the comparison of the toxicity of various regimes of pamaquin.

Standardized clinical trials diminished the influence of variables, such as acquired and natural immunity, variations in intensity of infection, the effect of suppressive drugs, and strain differences, which confuse the interpretation of results in field studies.

¹ This investigation was carried out under a contract, recommended by the Committee on Medical Research, between the Office of Scientific Research and Development and the University of Chicago. The work was planned in conjunction with the Panel on Clinical Testing of Antimalarials of the Board for the Coordination of Malarial Studies. This work was further aided by the participation of Army Medical Officers assigned to the project by The Surgeon General, U. S. Army.

Through a cooperative arrangment between Proffessor Clay G. Huff and Dr. Frederick Coultson, Department of Bacteriology and Parasitology, and the Malarial Research Unit, Department of Medicine, the former group bred Anopheles quadrimaculatus mosquitoes, supervised their infection and the inoculation of volunteers, and determined the intensity of infection in the salivary glands of the mosquitoes. The latter group assumed the responsibility for clinical care of patients studied by both groups.

² Captain, M.C., A.U.S.