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

Journal article

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.

Authors: Fryauff, D; Owusu-Agyei, S; Utz, G; Baird, J; Koram, K

• Publication status: Published
• Journal: American journal of tropical medicine and hygiene
• Volume: 76
• Issue: 2
• Pages: 224-231
• Publication date: 2007-02-01
• EISSN: 1476-1645
• ISSN: 0002-9637
• Language: English
• Keywords: Diarrhea; Vomiting; Female; Humans; Animals; Child, Preschool; Male; Antimalarials; Prospective Studies; Malaria, Falciparum; Plasmodium falciparum; Infant; Mefloquine; Ghana; Linear Models; Cohort Studies; Parasitemia