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Con A-pretreated mononuclear (MNC) cells from Thai adults with naturally acquired P. falciparum or P. vivax malaria were significantly less effective in suppressing the responsiveness of autologous or normal allogeneic responder cells to mitogenic lectins or allogenic stimulator cells than pretreated cells from healthy donors. Serial studies of three patients demonstrated that reduced suppressor cell activity was present early in malaria infection but returned to normal soon after treatment. These studies demonstrate that the loss of T cells previously observed in patients with malaria, in part may functionally represent a loss of suppressor T cells.
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In an area of Thailand where chloroquine-resistant falciparum malaria is known to exist, a chemosuppressive field trial was undertaken to test the efficacy of the preparation diformyldapsone (DFD) combined with pyrimethamine (Py) in suppressing falciparum and vivax parasitemias. Six hundred and fifty-nine Thai villagers were randomly assigned to one of five treatment groups: DFD-Py; dapsone (DDS)-Py; DFD alone; Py alone; and placebo. Five hundred and ninety-three study subjects completed the 26-week trial. The combination DFD-Py given weekly was shown to be an effective chemosuppressive against both falciparum and vivax parasitmias, causing a more than fourfold reduction in falciparum and an approximately threefold reduction in vivax parasitemias; however, this combination was not more efficacious than DDS-Py for the chemosuppression of falciparum malaria. DFD alone was only moderately effective, while there was no difference in chemosuppression between Py alone and placebo.
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