title: The relationship between the response of Plasmodium falciparum malaria to mefloquine in African children and its sensitivity in vitro.
abstract: The clinical efficacy of two doses of mefloquine (15 and 25 mg/kg body weight) was evaluated in 85 children suffering from acute symptomatic falciparum malaria. The cure rate on day 28 was 100% in both groups. There was no significant difference (P > 0.05) in the mean parasite and fever clearance times in both groups (48.5 +/- 14.6 and 32.0 +/- 12.7 h respectively for the 25 mg/kg group and 49.0 +/- 15.1 and 30.0 +/- 13.3 h respectively for the 15 mg/kg group). There was also no significant difference (P > 0.05) in these values between children with hyperparasitaemia (53.6 +/- 11.1 and 36.0 +/- 17.0 h respectively) and those without hyperparasitaemia (49.1 +/- 13.6 and 31.8 +/- 14.6 h respectively). Recurrence of parasitaemia was observed after day 30 in 2 patients in the 15 mg/kg group and in 1 patient in the 25 mg/kg group. In vitro, 3 of 21 isolates showed reduced susceptibility to mefloquine, with minimum inhibitory concentrations (MIC) > 67 nM/litre. The MIC and 50%, 90% and 99% inhibitory concentrations were 200.8, 6.27, 31.7 and 119.6 nM/litre respectively. Four of 22 isolates were resistant to chloroquine (MIC > 108 nM/litre). Isolates that showed low sensitivity to mefloquine in vitro were sensitive to chloroquine in vitro, and the 4 that were resistant to chloroquine were sensitive to mefloquine. Irrespective of MIC and dose of mefloquine, parasitaemia cleared in all subjects in 96 h or less.(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: Department of Pharmacology and Therapeutics, University of Ibadan, Nigeria.
authors.forename: A
authors.initials: A
authors.lastname: Sowunmi
authors.forename: A M
authors.initials: AM
authors.lastname: Oduola
authors.forename: L A
authors.initials: LA
authors.lastname: Salako
authors.forename: O A
authors.initials: OA
authors.lastname: Ogundahunsi
authors.forename: O J
authors.initials: OJ
authors.lastname: Laoye
authors.forename: O
authors.initials: O
authors.lastname: Walker
mesh_terms: D000208:Acute Disease; D000818:Animals; D002648:Child; D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D004351:Drug Resistance; D005260:Female; D006801:Humans; D016778:Malaria, Falciparum / Q000188:drug therapy*; D008297:Male; D015767:Mefloquine / Q000009:adverse effects / Q000627:therapeutic use*; D010963:Plasmodium falciparum / Q000187:drug effects; D016896:Treatment Outcome
chemical_list: D015767:Mefloquine