Efficacy of monthly tafenoquine for prophylaxis of Plasmodium vivax and multidrug-resistant P. falciparum malaria.
We assessed monthly doses of tafenoquine for preventing Plasmodium vivax and multidrug-resistant P. falciparum malaria. In a randomized, double-blind, placebo-controlled study, 205 Thai soldiers received either a loading dose of tafenoquine 400 mg (base) daily for 3 days, followed by single monthly 400-mg doses (n = 104), or placebo (n = 101), for up to 5 consecutive months. In volunteers completing follow-up (96 tafenoquine and 91 placebo recipients), there were 22 P. vivax, 8 P. falciparum, and 1 mixed infection. All infections except 1 P. vivax occurred in placebo recipients, giving tafenoquine a protective efficacy of 97% for all malaria (95% confidence interval [CI], 82%-99%), 96% for P. vivax malaria (95% CI, 76%-99%), and 100% for P. falciparum malaria (95% CI, 60%-100%). Monthly tafenoquine was safe, well tolerated, and highly effective in preventing P. vivax and multidrug-resistant P. falciparum malaria in Thai soldiers during 6 months of prophylaxis.
Walsh
Douglas S
DS
Department of Immunology and Medicine, United States Army Medical Component, Bangkok, Thailand. douglas.walsh@se.amedd.army.mil.
Eamsila
Chirapa
C
Sasiprapha
Theerayuth
T
Sangkharomya
Suebpong
S
Khaewsathien
Pradith
P
Supakalin
Panpaka
P
Tang
Douglas B
DB
Jarasrumgsichol
Phongsak
P
Cherdchu
Chainarong
C
Edstein
Michael D
MD
Rieckmann
Karl H
KH
Brewer
Thomas G
TG
D000284:Administration, Oral; D000634:Aminoquinolines / Q000627:therapeutic use*; D000818:Animals; D000962:Antimalarials / Q000627:therapeutic use*; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D018432:Drug Resistance, Multiple; D005500:Follow-Up Studies; D006801:Humans; D016778:Malaria, Falciparum / Q000517:prevention & control*; D016780:Malaria, Vivax / Q000517:prevention & control*; D008889:Military Personnel; D010963:Plasmodium falciparum / Q000187:drug effects*; D013785:Thailand; D016896:Treatment Outcome
D000634:Aminoquinolines; D000962:Antimalarials; C055852:tafenoquine