Chloroquine-induced pruritus among patients with malaria

Abstract

A questionnaire survey was performed among 550 acutely febrile patients with malaria to determine whether pruritus accompanied chloroquine therapy when the drug was employed to suppress paroxysmal febrile attacks. Eighty-one (74.3%) of the 109 respondents, including two Asian and one white patients, recalled the past occurrence of regular (60%) or occasional (40%) pruritus under those conditions, and 15 black patients (13.8%) under active treatment were currently experiencing itching. The typical pruritic reaction following chloroquine administration was generalized, began after a latency of 11 +/- 9 hours (mean +/- SD of 15 acute reactions), increased to a moderately severe peak of intensity within 25 +/- 12 hours, remained maximal for about 12 hours, and then gradually subsided completely 55 +/- 21 hours after onset. Antihistamines were largely ineffective for the relief of pruritus. These results suggest that certain undetermined factors, present in febrile patients with malaria, predispose to 4-aminoquinoline-induced pruritus. Black patients may have an increased susceptibility to this symptomatic drug reaction.

Drugs against chloroquine antimalarial itch

“…The 10 healthy unmedicated controls were also balanced for sex (5 males, 5 females), although there have been no reports of predisposition to chloroquine MAAP on the basis of sex [1,4]. Three trained female research assistants helped to canvass for the consent of patient volunteers and to record limb activity meter readings at night from the sleeping subjects.…”

“…An ordinal scale ranging from zero (no itch) to ten (maximal itch), as previously reported [1], was used to quantify the intensity of the itch.…”

“…used for the chemosuppression of acute febrile paroxysms of Plasmodium falciparum malaria in tropical Africa has aroused much research interest in recent times [1][2][3][4][5].…”

“…The validity of retrospective epidemiological surveys for making inferences in favour of a genetic basis for MAAP has been greatly weakened by observations that the high incidence of MAAP due to chloroquine, about 74% on University campuses in Benin City [1] and Ile-Ife [3], among questionnaire respondents, is not reproduced during prospective studies. The incidence of MAAP in prospective studies has not exceeded 25% in reports [1,4,13].…”

Effect of Petroleum Ether Fractions of Morinda lucida on Plasmodium berghei berghei in Mice

“…The drug control and eradication of the disease has been facing problems of adverse reactions (Rollo, 1980;Caussade, 1984;Osifo, 1984) and, more important, problems of drug resistant malaria parasites (WHO, 1985). The set backs suffered in the drug control and eradication of malaria have necessitated the need to identify new drugs (WHO, 1984).…”