In vivo sensitivity monitoring of mefloquine monotherapy and artesunate-mefloquine combinations for the treatment of uncomplicated falciparum malaria in Thailand in 2003
| Autor: | Sawat Cholpol, Chansuda Wongsrichanalai, Argat Nakavej, Duangduen Phoungmanee, Saowanit Vijaykadga, Chaiporn Rojanawatsirivej |
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| Rok vydání: | 2006 |
| Předmět: |
Adult
Male medicine.medical_specialty Chiang mai Adolescent Administration Oral Artesunate Drug resistance Drug Administration Schedule chemistry.chemical_compound Antimalarials Age Distribution Internal medicine medicine Humans Treatment Failure Malaria Falciparum Child Aged Mefloquine business.industry Public Health Environmental and Occupational Health Middle Aged medicine.disease Thailand Artesunate + mefloquine Artemisinins Surgery Infectious Diseases Clinical research Treatment Outcome chemistry Tropical medicine Parasitology Drug Therapy Combination Female business Sesquiterpenes Malaria medicine.drug |
| Zdroj: | Tropical medicineinternational health : TMIH. 11(2) |
| ISSN: | 1360-2276 |
| Popis: | The objective was to monitor the efficacy of anti-malarial treatments in Thailand. A 28-day in vivo study in nine provinces along international borders in 2003. The first group comprised 164 patients from four provinces: Mae Hong Son Chiang Mai Ratchaburi and Ubon Ratchathani. These patients received 15 mg/kg mefloquine as a single dose. The second group 58 patients from Kanchanaburi were treated with 15 mg/kg mefloquine plus artesunate (12 mg/kg). The third group 196 patients from provinces with high-level mefloquine resistance (Tak Ranong Chanthaburi and Trat) received 25 mg/kg of mefloquine plus 12 mg/kg artesunate. In all arms follow-up blood smears were scheduled for days 1 2 3 7 14 21 and 28. All patients tolerated the regimens well. The percentage of adequate clinical and parasitological response to mefloquine monotherapy was 62.0% in Mae Hong Son 75.0% in Chiang Mai 94.0% in Ratchaburi and 89.7% in Ubon Ratchathani. In Kanchanaburi the percentage of adequate clinical and parasitological response to the artesunate-mefloquine combination was 94.2%. In the third group this response exceeded 90% except in Trat where it was only 78.6% (44 patients). Mefloquine monotherapy must urgently be replaced in Mae Hong Son and Chiang Mai. The markedly reduced efficacy of the artesunate-mefloquine combination used in Trat raises questions about the future of this therapy on the southeastern border of Thailand with Cambodia. It is very worrying because no practical and affordable alternative is yet available. (authors) |
| Databáze: | OpenAIRE |
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