Efficacy of mefloquine and mefloquine–artesunate for the treatment of uncomplicated <i>Plasmodium falciparum</i> malaria in the Amazon region of Bolivia

Avila, Juan Carlos; Villaroel, Rodolfo; Marquiño, Wilmer; Zegarra, Jorge; Mollinedo, René; Ruebush, Trenton K.

doi:10.1046/j.1365-3156.2003.01184.x

Cited by 12 publications

(7 citation statements)

References 11 publications

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“…These 2 districts are targeted by routine residual insecticide house-spraying programs that use alphacypermethrin (coverage rate <60%). P. falciparum isolates are usually resistant to chloroquine and sulfadoxine/pyrimethamine ( 17 ), but no chloroquine-resistant P. vivax has been reported. Ethical approval for this study was obtained from the Bolivian Ministry of Health (National Institute of Health Laboratories, La Paz).…”

Section: Methodsmentioning

confidence: 99%

Plasmodium vivaxMalaria during Pregnancy, Bolivia

Brutus¹,

Santalla²,

Schneider³

et al. 2013

Emerg. Infect. Dis.

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Plasmodium vivax is a major cause of illness in areas with low transmission of malaria in Latin America, Asia, and the Horn of Africa. However, pregnancy-associated malaria remains poorly characterized in such areas. Using a hospital-based survey of women giving birth and an antenatal survey, we assessed the prevalence rates of Plasmodium spp. infections in pregnant women in Bolivia, and evaluated the consequences of malaria during pregnancy on the health of mothers and newborns. P. vivax infection was detected in 7.9% of pregnant women attending antenatal visits, and placental infection occurred in 2.8% of deliveries; these rates did not vary with parity. Forty-two percent of all P. vivax malaria episodes were symptomatic. P. vivax–infected pregnant women were frequently anemic (6.5%) and delivered babies of reduced birthweight. P. vivax infections during pregnancy are clearly associated with serious adverse outcomes and should be considered in prevention strategies of pregnancy-associated malaria.

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Section: Methodsmentioning

confidence: 99%

Plasmodium vivaxMalaria during Pregnancy, Bolivia

Brutus¹,

Santalla²,

Schneider³

et al. 2013

Emerg. Infect. Dis.

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“…It was also found to be an effective suppressive prophylactic drug, when administered weekly or fortnightly against drug-resistant Plasmodium falciparum [ 13 ]. The successful treatment of falciparum malaria with regimens of artemisinin derivatives plus mefloquine has been reported in other countries [ 14 - 17 ]. The pharmacokinetics of mefloquine combined with artesunate in children with acute falciparum malaria in Thailand has also been studied [ 18 ].…”

Section: Introductionmentioning

confidence: 99%

Efficacy, safety and tolerability of artesunate-mefloquine in the treatment of uncomplicated Plasmodium falciparum malaria in four geographic zones of Nigeria

Agomo

Meremikwu

Watila

et al. 2008

Malar J

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BackgroundThe combination of artesunate and mefloquine has been reported to be effective against multi-drug resistant Plasmodium falciparum malaria, which has been reported in Nigeria. The objective of this multi-centre study was to evaluate the efficacy, safety and tolerability of the co-packaged formulation of artesunate and mefloquine in the treatment of uncomplicated malaria in two weight groups: those between 15 – 29 kg and ≥ 30 kg respectively.MethodsThe trial was conducted in rural communities in the north-east, north-central, south-west and south-eastern parts of Nigeria. The WHO protocol for testing antimalarial drugs was followed. Outpatients having amongst other criteria, parasite density of ≥1,000 μl were enrolled. The co-packaged drugs were administered for 3 days at a dosage of artesunate, 4 mg/kg body wt/day and mefloquine, 25 mg/kg/body wt total) on days 0, 1 and 2. Patients were followed up for 28 days with the assessment of the parasitological parameters on days 1, 2, 3, 7, and 28.ResultsFour hundred and forty-six (446) patients were enrolled and 431 completed the study. Cure rates in both treatment groups was >90% at day 28. The mean parasite clearance times in treatment groups I and II were 40.1 and 42.4 hours respectively. The combination of artesunate and mefloquine showed good gametocidal activity, (gametocyte clearance time of 42.0 & 45.6 hours in treatment groups I and II respectively). There were no serious adverse events. Other adverse events observed were headache, dizziness, vomiting and abdominal discomfort. There was no significant derangement in the haematological and biochemical parameters.ConclusionThis co-packaged formulation of artesunate + mefloquine (Artequin™) is highly efficacious, safe and well-tolerated. It is recommended for the treatment of uncomplicated P. falciparum malaria in Nigeria.

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“…Since P. falciparum resistance to SP was first reported from the Amazon Basin in the 1960s, 14 it has become widespread. Because of the uniformly high levels of resistance to both CQ and SP, most countries making up the Amazon Basin have changed their malaria treatment policies in recent years to combination therapy with an artemisinin derivative 15,16 (K. Carter, personal communication).…”

Section: Discussionmentioning

confidence: 99%

Unusual Pattern of Plasmodium Falciparum Drug Resistance in the Northwestern Peruvian Amazon Region

Durand

Marquiño

Cabezas

et al. 2007

The American Journal of Tropical Medicine and Hygiene

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High levels of Plasmodium falciparum resistance to both chloroquine (CQ) and sulfadoxine-pyrimethamine (SP) have been documented throughout the Amazon Basin of South America. Because of reports about the persistent efficacy of both of these drugs in the northwestern Peruvian Amazon region, we carried out an evaluation of the therapeutic efficacy of chloroquine (25 mg/kg) and SP (25 mg/kg of the sulfadoxine component) for the treatment of uncomplicated P. falciparum infections at two sites: Ullpayacu and Pampa Hermoza/Alianza. A total of 111 patients were enrolled. Only 5 (14.3%) of the 35 patients who received CQ had an adequate clinical and parasitologic response (ACPR). Six subjects (17%) had early treatment failure, 1 (2.9%) had late clinical failure, and 23 (65.7%) had late parasitologic failure (LPF). Of the subjects treated with SP, 92.3% had ACPR and 7.7% had LPF. Based on these findings, it is clear that there are at least limited areas within the Peruvian Amazon region where P. falciparum strains continue to be sensitive to SP.

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Efficacy of mefloquine and mefloquine–artesunate for the treatment of uncomplicated Plasmodium falciparum malaria in the Amazon region of Bolivia

Cited by 12 publications

References 11 publications

Plasmodium vivaxMalaria during Pregnancy, Bolivia

Plasmodium vivaxMalaria during Pregnancy, Bolivia

Efficacy, safety and tolerability of artesunate-mefloquine in the treatment of uncomplicated Plasmodium falciparum malaria in four geographic zones of Nigeria

Unusual Pattern of Plasmodium Falciparum Drug Resistance in the Northwestern Peruvian Amazon Region

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