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Cited by 110Malaria Research and ControlPhytochemical compounds biological activitiesTravel-related health issues

Randomized comparison of mefloquine-artesunate versus quinine in the treatment of multidrug-resistant falciparum malaria in pregnancy

McGready, Rose, Brockman, Alan, Cho, Thein, Cho, Dju, van Vugt, Michele, Luxemburger, Christine, Chongsuphajaisiddhi, Tan, White, Nicholas J. +1 more·2000·Transactions of the Royal Society of Tropical Medicine and Hygiene
DOI 10.1016/s0035-9203(00)90235-9
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Abstract

Since no effective malaria prevention measures have been identified for pregnant women living on the western border of Thailand, prompt diagnosis and efficient treatment are paramount, although drug resistance in Plasmodium falciparum has narrowed the treatment options. An open randomized comparison of supervised quinine (10 mg salt/kg every 8 h) for 7 days (Q7) versus mefloquine 25 mg base/kg (total dose) plus artesunate 4 mg/kg per day for 3 days (MAS3) was conducted in 1995-97 in 108 Karen women with acute uncomplicated falciparum malaria in the second or third trimesters of pregnancy. The MAS3 regimen was more effective than the Q7 regimen: day 63 cure rates were 98.2% (95% CI 94.7-100) (n = 65) for MAS3 and 67.0% (95% CI 43x3-90x8) (n = 41) for Q7, P = 0x001. The MAS3 regimen was also associated with less gametocyte carriage; the average person-gametocyte-weeks for MAS3 was 2.3 (95% CI 0-11) and for Q7 was 46x9 (95% CI 26-78) per 1000 person-weeks, respectively (P < 0.001). MAS3 was significantly better tolerated. These evident advantages must be balanced against a possible increased risk of stillbirth with the use of mefloquine in pregnancy. Further randomized studies assessing the safety and efficacy of other artemisinin-containing combination regimens in pregnancy are needed urgently.

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Crossref · 10.1016/s0035-9203(00)90235-9

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  • High cure rates have been reported in Thailand for the combination of MQ+AS (cure rate of 98.2% at day 63).

    “High cure rates have been reported in Thailand, for the combination of MQ+AS (cure rate of 98.2% at day 63).126”

    From Malaria in pregnancy. (2013) · cites this paper as [126]

  • Data available indicate that ACTs are relatively safe for the foetus when taken after the first trimester of pregnancy.

    “Data available indicate that ACTs are relatively safe for the foetus when taken after the first trimester of pregnancy.”

    From Malaria in pregnancy. (2013) · cites this paper as [126]

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Authors
McGready, R., Brockman, A., Cho, T., Cho, D., van Vugt, M., Luxemburger, C., Chongsuphajaisiddhi, T., White, N. J., & Nosten, F.
Affiliations
  • Mahidol University (TH)
  • Shoklo Malaria Research Unit (TH)
  • John Radcliffe Hospital (GB)
Corresponding author
Nosten, François
ORCID
Venue
Transactions of the Royal Society of Tropical Medicine and Hygiene
Publisher
Oxford University Press (OUP)
Published
2000-11
Volume
94
Issue
6
Pages
689-693
ISSN
0035-9203 (ISSN-L)
DOI
10.1016/s0035-9203(00)90235-9
OpenAlex
W1968845059
Cited by
110
References
2
Citations by year
2026: 1 · 2025: 2 · 2024: 1 · 2021: 2 · 2020: 3 · 2019: 2 · 2018: 3 · 2017: 4 · 2016: 4 · 2015: 8 · 2014: 5 · 2013: 3 · 2012: 7
FWCI
3.13
Type
journal article
Language
en
Open access
closed
Locations
  • Transactions of the Royal Society of Tropical Medicine and Hygiene (publishedVersion)
  • PubMed (publishedVersion)
  • Pure Amsterdam UMC (publishedVersion)
  • Data Archiving and Networked Services (DANS) (submittedVersion)
Funders
Wellcome Trust
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Malaria Research and Control
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Phytochemical compounds biological activities
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Travel-related health issues
Keywords
mefloquine, artesunate, quinine, multidrug-resistant malaria, falciparum malaria, malaria in pregnancy, gametocyte carriage, cure rate, drug safety, artemisinin-based combination therapy, stillbirth risk
MeSH terms
Artesunate, Adolescent, Adult, Antimalarials, Drug Therapy, Combination, Female, Follow-Up Studies, Humans, Pregnancy, Recurrence, Sesquiterpenes, Pregnancy Complications, Parasitic, Mefloquine, Malaria, Falciparum, Drug Resistance, Multiple, Artemisinins

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