Efficacy and Effectiveness of Mefloquine and Artesunate Combination Therapy for Uncomplicated Plasmodium falciparum Malaria in the Peruvian Amazon

We evaluated the efficacy and effectiveness of mefloquine (MQ) plus artesunate (AS) to treat patients with uncomplicated malaria in the Peruvian Amazon Basin in April 2005-March 2006. Patients ≥ 1 year of age with fever (axillary temperature ≥ 37.5°C) or history of fever and Plasmodium falciparum mo...

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Bibliographic Details
Published in:The American journal of tropical medicine and hygiene 2011-09, Vol.85 (3), p.573-578
Main Authors: MACEDO DE OLIVEIRA, Alexandre, CHAVEZ, Jorge, PONCE DE LEON, Gabriel, DURAND, Salomon, ARROSPIDE, Nancy, ROBERTS, Jacquelin, CABEZAS, Cesar, MARQUINO, Wilmer
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Animals
Antibiotics. Antiinfectious agents. Antiparasitic agents
Antimalarials - therapeutic use
Antiparasitic agents
Biological and medical sciences
Child
Child, Preschool
Directly Observed Therapy
Drug Therapy, Combination
Female
Human protozoal diseases
Humans
Infectious diseases
Malaria
Malaria, Falciparum - drug therapy
Malaria, Falciparum - epidemiology
Male
Medical sciences
Middle Aged
Parasitic diseases
Peru - epidemiology
Pharmacology. Drug treatments
Plasmodium falciparum
Protozoal diseases
Young Adult
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Summary:We evaluated the efficacy and effectiveness of mefloquine (MQ) plus artesunate (AS) to treat patients with uncomplicated malaria in the Peruvian Amazon Basin in April 2005-March 2006. Patients ≥ 1 year of age with fever (axillary temperature ≥ 37.5°C) or history of fever and Plasmodium falciparum monoinfection were included. Patients received antimalarial treatment with MQ (12.5 mg/kg/day for two days) and AS (4.0 mg/kg/day for three days) either by directly observed therapy or without directly observed therapy. After a 28-day follow-up, treatment efficacy and effectiveness were assessed on the basis of clinical and parasitologic outcomes. Ninety-six patients were enrolled in each study group; nine patients were lost to follow-up. All patients, except for one in the observed group, demonstrated adequate clinical and parasitologic response; none had detectable parasitemia on day 3. The efficacy of MQ + AS efficacy was 98.9% (95% confidence interval = 94.1-100.0%) and the effectiveness was 100.0% (95% confidence interval = 95.9-100.0%). Our study shows that MQ + AS is highly efficacious in the Peruvian Amazon.
ISSN:0002-9637
1476-1645
DOI:10.4269/ajtmh.2011.11-0250