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Please use this identifier to cite or link to this item: http://repository.li.mahidol.ac.th/dspace/handle/123456789/26013
Title: Randomized comparison of mefloquine-artesunate versus quinine in the treatment of multidrug-resistant falciparum malaria in pregnancy
Authors: Rose McGready
Alan Brockman
Thein Cho
Dju Cho
Michele Van Vugt
Christine Luxemburger
Tan Chongsuphajaisiddhi
Nicholas J. White
François Nosten
Shoklo Malaria Research Unit
Mahidol University
John Radcliffe Hospital
Academic Medical Centre, University of Amsterdam
Keywords: Immunology and Microbiology;Medicine
Issue Date: 1-Jan-2000
Citation: Transactions of the Royal Society of Tropical Medicine and Hygiene. Vol.94, No.6 (2000), 689-693
Abstract: Since no effective malaria prevention measures have been identified for pregnant women living on the western border of Thailand, prompt diagnosis and efficient treatment are paramount, although drug resistance in Plasmodium falciparum has narrowed the treatment options. An open randomized comparison of supervised quinine (10 mg salt/kg every 8 h) for 7 days (Q7) versus mefloquine 25 mg base/kg (total dose) plus artesunate 4 mg/kg per day for 3 days (MAS3) was conducted in 1995-97 in 108 Karen women with acute uncomplicated falciparum malaria in the second or third trimesters of pregnancy. The MAS3 regimen was more effective than the Q7 regimen: day 63 cure rates were 98.2% (95% CI 94.7 - 100) (n=65) for MAS3 and 67.0% (95% CI 43.3-90.8) (n=41) for Q7, P=0.001. The MAS3 regimen was also associated with less gametocyte carriage; the average person-gametocyte-weeks for MAS3 was 2.3 (95% CI 0-11) and for Q7 was 46.9 (95% CI 26-78) per 1000 person-weeks, respectively (P<0.001). MAS3 was significantly better tolerated. These evident advantages must be balanced against a possible increased risk of stillbirth with the use of mefloquine in pregnancy. Further randomized studies assessing the safety and efficacy of other artemisinin-containing combination regimens in pregnancy are needed urgently.
URI: https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=0033659429&origin=inward
http://repository.li.mahidol.ac.th/dspace/handle/123456789/26013
ISSN: 00359203
Appears in Collections:Scopus 1991-2000

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