title: Single dose artemisinin-mefloquine treatment for acute uncomplicated falciparum malaria.
abstract: For the treatment of patients with acute falciparum malaria, the combination of artemisinin as a single dose with a single dose of mefloquine was studied in 4 separate prospective trials, comprising 405 adults and 139 children with uncomplicated falciparum malaria in 2 in-patient and 2 rural out-patient studies in Viet Nam. Adults received oral artemisinin and children artemisinin suppositories. Randomized comparative treatment schedules were: artemisinin alone for 5 d, mefloquine-sulfadoxine-pyrimethamine (MSP), or quinine plus sulfadoxine-pyrimethamine (SP). Parasite clearance times (PCT) were rapid for artemisinin treated inpatients (90%: 14.8-20.4 h) but also for patients receiving MSP (PCT 90%: 18.0 h) and quinine (PCT 90%: 22.5 h). The recrudescence rate (RI) during a 28 d follow-up period among the patients given artemisinin plus mefloquine was 15% in the adult in-patients and zero in the adult and children out-patients. RI in the artemisinin 5 d treatment group was 33.3%; among those given artemisinin plus SP it was 47.3% in in-patients and in out-patients 46.1%. In the MSP treated out-patients RI was 1.5% in adults and zero in children. Artemisinin as a single dose (oral in adults and as a suppository in children) in combination with mefloquine was effective in rapidly lowering parasitaemia and in preventing recrudescence in hospital in-patients and in out-patients attending a rural health clinic. MSP alone as a single dose also rapidly reduced parasitaemia (but not as quickly as the artemisinin-mefloquine combination in out-patient children) and prevented recrudescence.
authors.affiliation: Centre for Tropical Diseases (Cho Quan Hospital), Ho Chi Minh City, Viet Nam.
authors.forename: T H
authors.initials: TH
authors.lastname: Tran
authors.forename: K
authors.initials: K
authors.lastname: Arnold
authors.forename: T H
authors.initials: TH
authors.lastname: Nguyen
authors.forename: P L
authors.initials: PL
authors.lastname: Pham
authors.forename: T D
authors.initials: TD
authors.lastname: Nguyen
authors.forename: M C
authors.initials: MC
authors.lastname: Bui
authors.forename: M T
authors.initials: MT
authors.lastname: Le
authors.forename: Q P
authors.initials: QP
authors.lastname: Mach
authors.forename: H V
authors.initials: HV
authors.lastname: Le
authors.forename: P M
authors.initials: PM
authors.lastname: Pham
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000553:Ambulatory Care; D000962:Antimalarials / Q000627:therapeutic use*; D037621:Artemisinins; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D006760:Hospitalization; D006801:Humans; D016778:Malaria, Falciparum / Q000188:drug therapy*; D008297:Male; D015767:Mefloquine / Q000627:therapeutic use*; D008875:Middle Aged; D011446:Prospective Studies; D011739:Pyrimethamine / Q000627:therapeutic use; D011803:Quinine / Q000627:therapeutic use; D012717:Sesquiterpenes / Q000627:therapeutic use*; D013413:Sulfadoxine / Q000627:therapeutic use; D013488:Suppositories
chemical_list: D000962:Antimalarials; D037621:Artemisinins; D012717:Sesquiterpenes; D013488:Suppositories; D013413:Sulfadoxine; C031327:artemisinin; D011803:Quinine; D015767:Mefloquine; D011739:Pyrimethamine