title: Efficacy of monthly tafenoquine for prophylaxis of Plasmodium vivax and multidrug-resistant P. falciparum malaria.
abstract: 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.
authors.affiliation: Department of Immunology and Medicine, United States Army Medical Component, Bangkok, Thailand. douglas.walsh@se.amedd.army.mil.
authors.forename: Douglas S
authors.initials: DS
authors.lastname: Walsh
authors.forename: Chirapa
authors.initials: C
authors.lastname: Eamsila
authors.forename: Theerayuth
authors.initials: T
authors.lastname: Sasiprapha
authors.forename: Suebpong
authors.initials: S
authors.lastname: Sangkharomya
authors.forename: Pradith
authors.initials: P
authors.lastname: Khaewsathien
authors.forename: Panpaka
authors.initials: P
authors.lastname: Supakalin
authors.forename: Douglas B
authors.initials: DB
authors.lastname: Tang
authors.forename: Phongsak
authors.initials: P
authors.lastname: Jarasrumgsichol
authors.forename: Chainarong
authors.initials: C
authors.lastname: Cherdchu
authors.forename: Michael D
authors.initials: MD
authors.lastname: Edstein
authors.forename: Karl H
authors.initials: KH
authors.lastname: Rieckmann
authors.forename: Thomas G
authors.initials: TG
authors.lastname: Brewer
mesh_terms: 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
chemical_list: D000634:Aminoquinolines; D000962:Antimalarials; C055852:tafenoquine