Publication: Predictors of mefloquine treatment failure: A prospectivestudy of 1590 patients with uncomplicated falciparum malaria
Issued Date
1995-01-01
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ISSN
18783503
00359203
00359203
Other identifier(s)
2-s2.0-0029616401
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Mahidol University
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SCOPUS
Bibliographic Citation
Transactions of the Royal Society of Tropical Medicine and Hygiene. Vol.89, No.6 (1995), 660-664
Suggested Citation
Feiko O. Ter Kuile, Christine Luxemburger, FranÇois Nosten, Kyaw Lay Thwai, Tan Chongsuphajaisiddhi, Nicholas J. White Predictors of mefloquine treatment failure: A prospectivestudy of 1590 patients with uncomplicated falciparum malaria. Transactions of the Royal Society of Tropical Medicine and Hygiene. Vol.89, No.6 (1995), 660-664. doi:10.1016/0035-9203(95)90435-2 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/17333
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Title
Predictors of mefloquine treatment failure: A prospectivestudy of 1590 patients with uncomplicated falciparum malaria
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Abstract
The factors which identify patients at risk of treatment failure were characterized in 1590 children and adults with uncomplicated falciparum malaria treated with 15 or 25 mg/kg of mefloquine on the borders of Thailand. Six independent predictors of failure were identified using multiplelogistic regression. Age ≤2 years (odds ratio [OR] 4.54), 3-15 years (OR 4.4), vomiting <30 min after a single dose of 25 mg/kg (despite re-administration of the dose) (OR 2.5) and diarrhoea after treatment (OR 3.6) were the strongest predictors of failure by day 7. Parasitaemias >10 000/mm3(OR 1.4), and fever with a history of recent vomiting (OR 1.6) were risk factors for recrudescence of the infection between days 10 and 28. Patients treated with mefloquine in the previous 2 months were also at increased risk of failure (OR 2.38), particularly if they were anaemic (haematocrit <30%) (OR 5.96), which suggested that they had recrudescentinfections at presentation. Combined, these 6 factors identified half of all treatment failures. Vomitingand diarrhoea accounted for 24% of the early failures in children. Patients at increased riskof treatment failure should be monitored closely and given early alternative treatment if fever andparasites persist for ≥3 d. © 1995 Oxford University Press.