Page 3 - Bulletins No. 4, 1938 sulphanilamide (protosil) in the treatment of malaria

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SULPHANILAMIDE (PRONTOSIL) IN THE
TREATMENT OF MALARIA.

The discovery that sulphanilamide, besides its dramatic
action in streptococcal infection, also exerted a favourable
influence in such conditions as meningitis, gonorrhoea, and
cystitis encouraged investigators to test its action in all sorts of
infections. Thus reports have been published of its use in
plague, leptospirosis, typhus and many other diseases—in fact
there can be very few infectious diseases left which have not
been treated with sulphanilamide by some one.
The first report of its use in protozoal infections was made
by De Leon (1937) who recorded successful results in fifteen
cases of P. vivax malaria. Further favourable reports have
been made by Hill and Goodwin (1937). Van der Wielen (1937)
records a case of therapeutic P. malaria malaria in which the
parasites disappeared apparently owing to the use of prontosil
for a coincidental cystitis. Chopra and Das Gupta (193S) claim
that "it may be stated with certainty that sulphanilamide
compounds are effective- specific drugs for malaria". This claim
is based on De Leon's report and their own experience in one
case of monkey malaria.
In view of these findings it was decided to test the action
of sulphanilamide in local malaria.
TlTe cases treated were cases admitted to the General
Hospital, Kuala Lumpur, and were adult Chinese and Indians
of the labouring class. The experiment was controlled by a
parallel series of cases treated with quinine bihydrochloride. In
all 148 cases of malaria came under notice divided as follows:
p. falciparum. P. vitar. P. malaria. Total.
Sulphanilamide treated ... 34 ... 3S ... 8 ... SO
Quinine treated 30 ... 38 ... — ••• 68
The allocation to the two groups was done for the most
part alternately without selection except that cases which did
not satisfy the standards of a temperature over 99°F. and an
asexual parasite count in the peripheral blood of over 1,000 per
cubic millimeter were not included in the series. Mixed infec-
tions were also rejected.