Six-years monitoring the efficacy of the combination of artesunate and mefloquine for the treatment of uncomplicated falciparum malaria.

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dc.contributor.authorWattanakoon, Yupapornen_US
dc.contributor.authorChittamas, Suneeen_US
dc.contributor.authorPornkulprasit, Vichitraen_US
dc.contributor.authorKanda, Tozoen_US
dc.contributor.authorThimasarn, Krongthongen_US
dc.contributor.authorRojanawatsirivej, Chaipornen_US
dc.contributor.authorLooareesuwan, Sornchaien_US
dc.contributor.authorBunnag, Danaien_US
dc.date.accessioned2009-05-27T15:40:08Z
dc.date.available2009-05-27T15:40:08Z
dc.date.issued2003-09-30en_US
dc.descriptionThe Southeast Asian Journal of Tropical Medicine and Public Health.en_US
dc.description.abstractPlasmodium falciparum in Thailand is multi-drug resistant. In a previous study it was shown that artesunate and mefloquine were effective, as follow up, we monitored the efficacy of this regimen for six years. During 1997-2002, 516 adult male volunteer patients in Chanthaburi Province were enrolled (50 patients in the first year, 400 patients in 1998-2001 and 66 patients in 2002). The symptom complex and parasite count (thick blood film) were monitored on days 0, 1, 2, 7, 14, 21, 28, 35 and 42. The dosages used were artesunate (ATS) 150 mg and mefloquine (M) 750 mg at hour 0 and ATS 100 mg and M 500 mg at hour 24. Their ages ranged from 30-35 years and their mean body weights were 54-56 kg. The presenting symptoms were fever 100%, headache 97-100%, anorexia 78-90%, and nausea 28-40%. The geometric mean of parasitemia ranged from 7,357-12,750/mm3. Defervescence in one day was found in 42-76% of patients and 85-100% in 2 days. The sensitivity (S) ranged from 87-94% and RI resistance (recrudescence) ranged from 6-13%. Forty patients demonstrated RI type of response, 37 were cured after being retreated with the same dosage and another 3 patients were cured after the third course of treatment. The aggravated adverse effects included vomiting (8-20%), anorexia (1-41%) and diarrhea (0-16%). These side effects were mild and transient. The efficacy of the artesunate and mefloquine combination for the treatment of uncomplicated falciparum malaria was high. The RI type of response was possibly due to re-infection or multiple broods and not to drug resistance. The adverse effects of anorexia, nausea, vomiting and diarrhea were mild and transient for mefloquine. The combination can be used as stand by treatment in areas of multi-drug resistant falciparum malaria.en_US
dc.description.affiliationFaculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.en_US
dc.identifier.citationWattanakoon Y, Chittamas S, Pornkulprasit V, Kanda T, Thimasarn K, Rojanawatsirivej C, Looareesuwan S, Bunnag D. Six-years monitoring the efficacy of the combination of artesunate and mefloquine for the treatment of uncomplicated falciparum malaria. The Southeast Asian Journal of Tropical Medicine and Public Health. 2003 Sep; 34(3): 542-5en_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/33362
dc.language.isoengen_US
dc.source.urihttps://www.tm.mahidol.ac.th/seameo/2003_34_3/10A-3226.pdfen_US
dc.subject.meshAdolescenten_US
dc.subject.meshAdulten_US
dc.subject.meshAnimalsen_US
dc.subject.meshAntimalarials --adverse effectsen_US
dc.subject.meshArtemisinins --adverse effectsen_US
dc.subject.meshDrug Resistance, Multipleen_US
dc.subject.meshDrug Therapy, Combinationen_US
dc.subject.meshHumansen_US
dc.subject.meshMalaria, Falciparum --drug therapyen_US
dc.subject.meshMaleen_US
dc.subject.meshMefloquine --adverse effectsen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshPlasmodium falciparum --drug effectsen_US
dc.subject.meshSesquiterpenes --adverse effectsen_US
dc.subject.meshThailanden_US
dc.titleSix-years monitoring the efficacy of the combination of artesunate and mefloquine for the treatment of uncomplicated falciparum malaria.en_US
dc.typeClinical Trialen_US
dc.typeJournal Articleen_US
dc.typeMulticenter Studyen_US
dc.typeResearch Support, Non-U.S. Gov'ten_US
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