F. M. SmithuisF. MontiM. GrundlA. Zaw OoT. T. KyawO. PheN. J. WhiteArisen Zonder GrenzenVector Borne Disease ControlMahidol UniversityNuffield Department of Clinical MedicineUNICEF2018-07-042018-07-041997-01-01Transactions of the Royal Society of Tropical Medicine and Hygiene. Vol.91, No.4 (1997), 468-472003592032-s2.0-0030751387https://repository.li.mahidol.ac.th/handle/20.500.14594/17998In Rakhine State, on the western border of Myanmar, the efficacy of chloroquine (CQ) and pyrimethamine/sulfadoxine (PS), the current treatments for uncomplicated Plasmodium falciparum malaria in this area, was evaluated in an open comparative study of 289 patients, stratified prospectively into 3 age groups. Chloroquine treatment was associated with more rapid clinical recovery (P = 0.03), but the overall cure rates were worse than for PS treatment; failure to clear parasitaemia or recrudescence within 14 d occurred in 72% (102/141) of cases treated with CQ compared to 47% (69/148) of those who received PS (P < 0.0001, adjusted for age). Failure rates at day 28 increased to 82% (116/141) in the CQ group and 67% (99/148) in the PS group (P = 0.003). The risk of treatment failure was significantly higher in children under 15 years old than in adults for both CQ (relative risk [RR] = 2.6; 95% confidence interval [95% CI] 1.3-5.2) and PS (RR = 2.2; 95% CI 1.4-3.3). Mefloquine (15 mg base/kg) proved to be highly effective as a treatment for CQ and PS resistant P. falciparum; only 2 of 75 patients (3%) had early treatment failures (≤ day 7), and the overall failure rate by day 42 was 7%. There is a very high level of chloroquine and PS resistance in P. falciparum on the western border of Myanmar, but mefloquine was effective in the area.Mahidol UniversityImmunology and MicrobiologyMedicineArticleSCOPUS10.1016/S0035-9203(97)90288-1