Publication: Quinine and mefloquine in the treatment of multidrug-resistant Plasmodium falciparum malaria in pregnancy
Issued Date
1998-01-01
Resource Type
ISSN
00034983
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2-s2.0-0032322687
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Mahidol University
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SCOPUS
Bibliographic Citation
Annals of Tropical Medicine and Parasitology. Vol.92, No.6 (1998), 643-653
Suggested Citation
R. McGready, T. Cho, L. Hkirijaroen, J. Simpson, T. Chongsuphajaisiddhi, N. J. White, F. Nosten Quinine and mefloquine in the treatment of multidrug-resistant Plasmodium falciparum malaria in pregnancy. Annals of Tropical Medicine and Parasitology. Vol.92, No.6 (1998), 643-653. doi:10.1080/00034983.1998.11813324 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/18409
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Title
Quinine and mefloquine in the treatment of multidrug-resistant Plasmodium falciparum malaria in pregnancy
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Abstract
Between 1991 and 1996, 372 pregnant women with uncomplicated, multidrug-resistant Plasmodium falciparum malaria, living on the western border of Thailand, were treated with either mefloquine (N = 194), quinine (N = 93) or both drugs (N = 85). Antimalarial treatment was generally well tolerated; the most common side-effects were dizziness (42%) and tinnitus (35%) following quinine, and anorexia (23%) and dizziness (36%) following mefloquine. In the patients treated for primary infections with mefloquine, 6% failed to clear their parasitaemia by day 7 and 28% failed by day 42. The corresponding figures for quinine were 4% and 23%, respectively. The failure rates in the 117 women treated for recrudescent infections were higher, the increase being significant for quinine (38%; P = 0.03) but not for mefloquine (37%). The percentage of pregnant women mho had patent gametocytaemia on presentation ranged from 4%-19%. Over 50% of the patients were anaemic (haemarocrit < 30%) on presentation and 52% of those not anaemic on enrolment developed anaemia during follow-up. Mefloquine and quinine, the only antimalarials generally available for the treatment of highly drug-resistant P. falciparum in pregnancy, give unsatisfactory treatment responses when used as single agents. New, safe and effective regimens are needed for the treatment of pregnant women with multidrug-resistant falciparum malaria.