The effectiveness of chemoprophylaxis against malaria for non-immune migrant workers in eastern Thailand

• Published in: Transactions of the Royal Society of Tropical Medicine and Hygiene Vol. 83; no. 3; pp. 313 - 315
• Main Authors: Kamolratanakul, P., Viputsiri, O., Dhanamun, B., Hirunabut, S., Mekmasin, A., Thongsawat, P.
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Ltd 01.05.1989; Royal Society of Tropical Medicine and Hygiene; Elsevier
• Subjects: Adult; Animals; Biological and medical sciences; Double-Blind Method; Drug Combinations; Female; Human protozoal diseases; Humans; Infectious diseases; Malaria; Malaria - immunology; Malaria - prevention & control; Male; Medical sciences; Mefloquine - therapeutic use; Parasitic diseases; Plasmodium falciparum; Plasmodium vivax; Protozoal diseases; Pyrimethamine - therapeutic use; Randomized Controlled Trials as Topic; Sulfadoxine - therapeutic use; Sulfanilamides - therapeutic use; Thailand; Tropical medicine; Thailand; Human; Protozoa; Antimalarial; Protozoal disease; Chemoprophylaxis; Malaria; Thailand; Infection; Plasmodium falciparum; Plasmodium vivax; Foreign worker; Asia; Sporozoa
• ISSN: 0035-9203; 1878-3503
• DOI: 10.1016/0035-9203(89)90485-9

A randomized, double-blind field trial was carried out to compare the effectiveness of mefloquine plus sulfadoxine-pyrimethamine (MSP) with that of sulfadoxine-pyrimethamine (SP) in chemoprophylaxis against malaria. The study was conducted in 193 migrant workers in the eastern rural areas of Thailand which are known to be highly endemic for multidrugresistant Plasmodium falciparum infection. MSP was found to be more effective than SP in the suppression of both P. falciparum and P. vivax parasitaemias, when administered weekly for 12 weeks ( P = 0·0014). Complete suppression of P. falciparum was achieved by MSP while 8 subjects receiving SP developed parasitaemia. One subject in the MSP group developed P. vivax parasitaemia, compared with 4 in the SP group. However, in view of the reported complications associated with the use of long-acting sulphonamides, some of which can be life threatening, prophylactic regimens containing sulfadoxine, though proved efficacious, must be used with extreme caution.