Mefloquine treatment for uncomplicated falciparum malaria in young children 6-24 months of age in northern Ghana.


Fryauff, DJ; Owusu-Agyei, S; Utz, G; Baird, JK; Koram, KA; Binka, F; Nkrumah, F; Hoffman, SL; (2007) Mefloquine treatment for uncomplicated falciparum malaria in young children 6-24 months of age in northern Ghana. The American journal of tropical medicine and hygiene, 76 (2). pp. 224-31. ISSN 0002-9637

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Abstract

Mefloquine (MQ) single dose 20 mg/kg treatment of falciparum malaria was evaluated in 186 children of 6-24 months of age in northern Ghana. There were 15 RII/RIII-type parasitologic failures, all with Day 2 MQ blood levels significantly lower than children whose parasitemias cleared before Day 7 and remained clear through 28 days. Predictors of RII/RIII parasitologic response were vomiting after MQ dosing, Day 2 MQ levels < 500 ng/mL, and undetectable Day 2 levels of the carboxymefloquine metabolite. There were 50 cases of delayed RI parasitologic failure, but 71% of these cases had undetectable Day 28 blood levels of MQ and drug levels in the remaining 29% ranged below the 620 ng/mL level that suppresses MQ sensitive strains of P. falciparum. Drug levels among infants that tolerated MQ well were not associated with age, weight, hemoglobin, parasitemia, and pre-existing symptoms of vomiting or diarrhea. An observed recurrent parasitemia of 34,400 trophozoites/microL against a MQ blood concentration of 550 ng/mL was taken as indication of tolerance to suppressive levels of the drug at this location.

Item Type: Article
Faculty and Department: Faculty of Infectious and Tropical Diseases > Dept of Disease Control
Research Centre: Malaria Centre
PubMed ID: 17297028
Web of Science ID: 244142200004
URI: http://researchonline.lshtm.ac.uk/id/eprint/1319741

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