title: Questionnaire-based analysis of atovaquone-proguanil compared with mefloquine in the chemoprophylaxis of malaria in non-immune Japanese travelers.
abstract: Malaria is one of the most common and serious infectious diseases in the tropics and subtropics. For high-risk travelers to endemic regions, malaria chemoprophylaxis is recommended. Internationally, atovaquone-proguanil (A/P), mefloquine (MEF), or doxycycline (DOX) are the prescribed malaria chemoprophylactic drugs. However, A/P and DOX are not approved in Japan. Therefore, the data on A/P for malaria chemoprophylaxis in Japanese travelers are not clear. We analyzed questionnaire survey data obtained in Hibiya Clinic to assess the safety and tolerability of A/P and compare them with those of MEF for non-immune Japanese travelers. A/P was given to 278 travelers and MEF to 38 travelers. The mean duration of each prophylaxis is for 20.0 ± 9.6 and 59.0 ± 15.9 days, respectively. Nine travelers discontinued prophylaxis: 5 in the A/P prescribed group (A/P group) and 4 in the MEF prescribed group (MEF group), and the rate of discontinuation was significantly less in the A/P group. The frequency of adverse events was significantly less in the A/P group than in the MEF group [52 cases (18.8 %) vs. 14 cases (36.8 %), respectively]. In particular, the frequency of psychoneurotic adverse events was significantly less in the A/P group. These results suggest that A/P is better tolerated and has fewer adverse events than MEF in non-immune Japanese travelers.
authors: Hibiya-Clinic, 1-5-2 Yurakucho, Chiyoda-ku, Tokyo, 100-0006, Japan. katetsu@av5.mopera.ne.jp
authors: Tetsuro
authors: T
authors: Kato
authors: Joji
authors: J
authors: Okuda
authors: Daisuke
authors: D
authors: Ide
authors: Katsushi
authors: K
authors: Amano
authors: Yutaka
authors: Y
authors: Takei
authors: Yuko
authors: Y
authors: Yamaguchi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000962:Antimalarials / Q000009:adverse effects / Q000627:therapeutic use*; D053626:Atovaquone / Q000009:adverse effects / Q000627:therapeutic use*; D018890:Chemoprevention; D002648:Child; D004338:Drug Combinations; D005260:Female; D006801:Humans; D007564:Japan; D008288:Malaria / Q000517:prevention & control*; D008297:Male; D015767:Mefloquine / Q000009:adverse effects / Q000627:therapeutic use*; D008875:Middle Aged; D002727:Proguanil / Q000009:adverse effects / Q000627:therapeutic use*; D011795:Surveys and Questionnaires; D014195:Travel; D055815:Young Adult
chemical_list: D000962:Antimalarials; D004338:Drug Combinations; C109496:atovaquone, proguanil drug combination; D002727:Proguanil; D015767:Mefloquine; D053626:Atovaquone