Original article - Ethiopian Review

Participating children were randomly allocated into the two treatment groups using table of randomnumbers.Group one received cotrimoxazole at standard dosage (trimethoprim 6mg/sulphamethoxazole30mg/kg body weight in two divided doses daily, administered orally as syrup, crushed powder ortablets) for three days.Group two received the standard regimen of chloroquine base (10mg chloroquine phosphatebase/kg of body weight followed by 5mg/kg 6-8 hours later and 5mg/kg on each of the second andthird days orally as syrup, crushed powder or tablets) and procaine penicillin at a dose of 50,000units/kg body weight intramuscular daily for five days.All patients were invited for a return visit on the 7th and 14th days after initiation of treatment.To improve compliance, the cost of medication, investigation and transportation were covered bythe research fund and it was explained that the child would be seen at each visit with the minimumof waiting time.During each follow up visit, parents were asked about the compliance with the medicationregimen and whether their child had been ill or had experienced fever, cough, difficulty inbreathing, vomiting, diarrhoea or poor appetite. The child was examined for the presence of chestindrawing and other danger signs. The temperature and respiratory rates were recorded and bloodfilm performed.Malaria therapy was considered to have been successful if no parasites were detected on dayseven and 14. All patients with parasitaemia on day seven were treated with a single dose ofFansidar (25mg pyrimethamine and 500 mg sulfadoxine).A child was considered ill if he or she had fever and/or one more symptom of vomiting,diarrhoea, cough or loss of appetite or three of these symptoms without fever. The overallcondition was recorded as worsened, same or improved.Clinical malaria was diagnosed in the presence of a fever or history of fever. Fever was definedas an axillary temperature of 37.5 or more. Clinical pneumonia was diagnosed in the presence ofchest indrawing, cough or difficulty in breathing with a rapid breathing rate of 60 per minute ormore for children less than two months of age; 50 or more breathe for children 2-11 month of age;and 40 or more for children 12 months of age or older. Severe pneumonia was diagnosed if chestindrawing was present.