Long-term malaria prophylaxis with weekly mefloquine

• Published in: The Lancet (British edition) Vol. 341; no. 8849; pp. 848 - 851
• Main Authors: Lobel, H.O, Campbell, C.C, Hightower, A.H, Eng, T, Miani, M, Bernard, K.W
• Format: Journal Article
• Language: English
• Published: London Elsevier Ltd 03.04.1993; Lancet; Elsevier Limited
• Subjects: Africa, Western - epidemiology; Antibiotics. Antiinfectious agents. Antiparasitic agents; Antiparasitic agents; Biological and medical sciences; Chloroquine; Chloroquine - administration & dosage; Chloroquine - adverse effects; Chloroquine - therapeutic use; Cohort Studies; Drug Administration Schedule; Drug Therapy, Combination; Drugs; Humans; Long-Term Care; Malaria; Malaria, Falciparum - epidemiology; Malaria, Falciparum - prevention & control; Medical research; Medical sciences; Mefloquine; Mefloquine - administration & dosage; Mefloquine - adverse effects; Mefloquine - blood; Mefloquine - therapeutic use; Pharmacology. Drug treatments; Plasmodium; Proguanil; Proguanil - administration & dosage; Proguanil - therapeutic use; Prophylaxis; Side effects; Travellers; Vector-borne diseases; Africa, Western; Infection; Human; Prevention; Protozoal disease; Chemotherapy; Treatment; Malaria; Weekly; Parasiticid; Long term
• ISSN: 0140-6736; 1474-547X
• DOI: 10.1016/0140-6736(93)93058-9

The spread of chloroquine-resistant Plasmodium falpicarum malaria has led to increased use of mefloquine prophylaxis by US Peace Corps volunteers in sub-Saharan Africa. We compared long-term mefloquine with other drug regimens for effectiveness and tolerance. The incidence of Plasmodium falciparuminfections and of adverse reactions was compared in Peace Corps volunteers who took chloroquine weekly, mefloquine weekly, mefloquine every other week, or weekly chloroquine plus daily proguanil. Weekly mefloquine was 94% more effective than chloroquine (95% Cl 86% to 97%), 86% more effective than chloroquine plus proguanil (95% Cl 67% to 94%), and 82% more effective than prophylaxis with mefloquine when taken every other week (95% Cl 68% to 90%). No serious adverse reactions were observed. Mild adverse events were equally frequent in mefloquine users and chloroquine users, and the frequency of these events declined with increasing duration of prophylaxis. Mefloquine is an effective and well-tolerated drug for prophylaxis of malaria by short-term and long-term travellers.