title: Efficacy and safety of artesunate-mefloquine therapy for treating uncomplicated Plasmodium falciparum malaria: systematic review and meta-analysis.
abstract: The present study is a systematic review of the literature on the efficacy and safety of the treatment of uncomplicated Plasmodium falciparum infections with artesunate-mefloquine (ASMQ) compared to other artemisinin-based combination therapies (ACTs), designed to assist decision makers in Brazil.
  
  
  
  Twenty-four randomized controlled trials (RCTs) were selected in four electronic databases and in complementary sources. Meta-analyses were performed to evaluate the efficacy expressed by relative risks (RR) obtained from treatment failure confirmed by the PCR.
  
  
  
  Due primarily to the presence of measurement bias in the selected studies, the quality of the evidence was considered predominantly moderate. Statistically significant associations were not observed when ASMQ was compared to artemether-lumefentrine and dihydroartemisinin-piperaquine. The results of studies performed in areas with a history of use of ASMQ, regardless of the intensity of transmission, were not statistically different from those presented in the meta-analyses. For comparisons with artesunate-amodiaquine and artesunate+sulfadoxine-pyrimethamine, the results were favourable to ASMQ. No deaths were attributed to ASMQ, severe adverse events were rare and some studies indicate a higher frequency of mild adverse events.
  
  
  
  The use of ASMQ it is recommended to Brazil as first line treatment of uncomplicated P. falciparum infections.
authors.affiliation: Centre for Tropical Medicine, University of Brasília, Brasília, Federal District, Brazil henrymaiap9@gmail.com.|University Centre of Brasília, Brasília, Federal District, Brazil.|National Institute for Science and Technology for Health Technology Assessment (IATS/CNPq), Porto Alegre, Rio Grande do Sul, Brazil.
authors.forename: Henry Maia
authors.initials: HM
authors.lastname: Peixoto
authors.affiliation: Ministry of Health, Secretariat of Health Surveillance, Brazil.
authors.forename: Paola Barbosa
authors.initials: PB
authors.lastname: Marchesini
authors.affiliation: Centre for Tropical Medicine, University of Brasília, Brasília, Federal District, Brazil.|National Institute for Science and Technology for Health Technology Assessment (IATS/CNPq), Porto Alegre, Rio Grande do Sul, Brazil.
authors.forename: Maria Regina Fernandes
authors.initials: MR
authors.lastname: de Oliveira
keywords: Artemisinin-based combination therapy; Artesunate-mefloquine; Efficacy; Malaria; Plasmodium falciparum; Treatment