title: Chemosuppression of malaria by the triple combination mefloquine/sulfadoxine/pyrimethamine: a field trial in an endemic area in Malaysia.
abstract: Malaria, particularly that due to chloroquine-resistant Plasmodium falciparum, which requires management with antimalarial drugs capable of protecting against multiresistant strains, has emerged in Malaysia. A study was carried out to assess the efficacy and tolerability of 2 dosages of mefloquine/sulfadoxine/pyrimethamine (MSP; RO 13-5112) compared to Fansidar in a malaria endemic area. 914 subjects in 3 random groups were studied. Occurrence of malaria was assessed both clinically as well as by blood films. Plasma drug levels were also measured. The results showed that the low dose of MSP was completely effective in suppressing parasitaemia. 2.7% of the study population reported adverse drug reactions, the lowest incidence being in subjects on the low dose; their blood chemical profiles were also the least affected. The plasma levels of pyrimethamine and sulfadoxine achieved in the low dose group were slightly higher than expected, but there was no significant difference in bioavailability. The study showed that, for chemoprophylaxis, a low dose of MSP provided effective protection with minimal side effects.
authors.affiliation: National Drug Research Centre, University Sains Malaysia, Pulau Pinang.
authors.forename: V
authors.initials: V
authors.lastname: Navaratnam
authors.forename: M
authors.initials: M
authors.lastname: Mohamad
authors.forename: S
authors.initials: S
authors.lastname: Hussain
authors.forename: A
authors.initials: A
authors.lastname: Kumar
authors.forename: A
authors.initials: A
authors.lastname: Jamaludin
authors.forename: I
authors.initials: I
authors.lastname: Sulaiman
authors.forename: S
authors.initials: S
authors.lastname: Mahsufi
authors.forename: K
authors.initials: K
authors.lastname: Selliah
mesh_terms: D000818:Animals; D002738:Chloroquine / Q000627:therapeutic use; D004338:Drug Combinations / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D006400:Hematocrit; D006801:Humans; D007958:Leukocyte Count; D008288:Malaria / Q000188:drug therapy* / Q000453:epidemiology; D008296:Malaysia / Q000453:epidemiology; D015767:Mefloquine / Q000097:blood / Q000627:therapeutic use*; D010963:Plasmodium falciparum / Q000187:drug effects; D011739:Pyrimethamine / Q000097:blood / Q000627:therapeutic use*; D011897:Random Allocation; D013413:Sulfadoxine / Q000097:blood / Q000627:therapeutic use*; D013424:Sulfanilamides / Q000627:therapeutic use*
chemical_list: D004338:Drug Combinations; D013424:Sulfanilamides; C001205:fanasil, pyrimethamine drug combination; D013413:Sulfadoxine; D002738:Chloroquine; D015767:Mefloquine; D011739:Pyrimethamine