[Mefloquine versus halofantrine in children suffering from acute uncomplicated falciparum malaria].
OBJECTIVE
To evaluate mefloquine versus halofantrine in children suffering from acute uncomplicated falciparum malaria.


METHODS
Prospective non randomized study in hospitalized children during one year. Acute falciparum malaria was defined by fever and a positive thin and/or thick smear. Malaria was presumed to have been contracted in Comoros archipelago and/or Madagascar 6 months previously. Patients were excluded, when quinine had to be used, according to World Health Organization's severity criteria.


RESULTS
Forty-nine children were included: 29 were treated with halofantrine and 20 with mefloquine. Patients features in the two groups of treatment were identical, with exception for the mean time between first clinical signs and diagnosis (shorter in mefloquine group). Fever's and hospitalization's duration under treatment were similar. An increase in QTc interval was frequently observed in patients treated with halofantrine (56 versus 0%), although patients with mefloquine experienced vomiting (45 versus 0%). Relapses seemed to be more frequent with halofantrine (14 versus 0%).


CONCLUSIONS
Halofantrine and mefloquine are efficient for falciparum malaria treatment in our pediatric series, despite a high rate of adverse events. Mefloquine's tolerance may probably be improved with changes in regimen and dose. Relapses are more frequent with a single first treatment of halofantrine, than with mefloquine. Unfortunately, features of a second halofantrine treatment are not defined.
Minodier
P
P
Urgences pédiatriques, CHU Nord, chemin des Bourrelly, 13915 Marseille cedex 20, France. philippe.minodier@ap-hm.fr
Noël
G
G
Salles
M
M
Retornaz
K
K
Walters
H
H
Combes
J C
JC
Garnier
J M
JM
D000293:Adolescent; D000962:Antimalarials / Q000009:adverse effects* / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008133:Long QT Syndrome / Q000139:chemically induced; D016778:Malaria, Falciparum / Q000188:drug therapy*; D008297:Male; D015767:Mefloquine / Q000009:adverse effects* / Q000627:therapeutic use*; D010616:Phenanthrenes / Q000009:adverse effects* / Q000627:therapeutic use*; D016896:Treatment Outcome
D000962:Antimalarials; D010616:Phenanthrenes; C023768:halofantrine; D015767:Mefloquine