Cookies on this website
We use cookies to ensure that we give you the best experience on our website. If you click 'Continue' we'll assume that you are happy to receive all cookies and you won't see this message again. Click 'Find out more' for information on how to change your cookie settings.

On the western border of Thailand, in an area endemic for multi-drug resistant Plasmodium falciparum malaria, therapeutic responses were assessed in 1967 patients with uncomplicated falciparum malaria treated with 3 d of artesunate (total dose 12 mg/kg) plus mefloquine (total dose 25 mg/kg). The regimen was well tolerated and resulted in a rapid clinical response; within 48 h, 96% of patients were aparasitaemic and 94% were afebrile. After correcting for reinfections, the cure rate by day 42 was 89% (95% confidence interval [95% CI] 87-91%). Three independent factors were found to predict recrudescence: age < 14 years (adjusted hazards ratio [AHR] = 1.6, 95% CI 1.1-2.3), initial parasitaemia greater than > 40,000/microL (AHR = 1.6, 95%, CI 1.2-2.2), and pure P. falciparum infections (AHR = 1.8, 95% CI 1.3-2.7). These 3 factors combined accounted for 62% of all treatment failures. Patients who received mefloquine on admission with a high admission parasitaemia (> 40,000/microL) had a three-fold (95% CI 1.3-7) risk of subsequent recrudescence compared with those who received their mefloquine on the second or third day (P = 0.01). There has been no decline in the efficacy of the 3 d artesunate plus mefloquine regimen since it was introduced in 1992. This regimen is safe, well tolerated, and highly effective in the treatment of multi-drug resistant falciparum malaria.

Original publication

DOI

10.1016/s0035-9203(97)90032-8

Type

Journal article

Journal

Trans R Soc Trop Med Hyg

Publication Date

09/1997

Volume

91

Pages

574 - 577

Keywords

Adolescent, Adult, Aged, Antimalarials, Artemisinins, Artesunate, Child, Child, Preschool, Drug Resistance, Multiple, Drug Therapy, Combination, Endemic Diseases, Female, Fever, Follow-Up Studies, Humans, Infant, Malaria, Falciparum, Male, Mefloquine, Middle Aged, Parasitemia, Prospective Studies, Recurrence, Risk Factors, Sesquiterpenes, Thailand, Treatment Outcome