Questionnaire-based analysis of atovaquone–proguanil compared with mefloquine in the chemoprophylaxis of malaria in non-immune Japanese travelers

Abstract Malaria is one of the most common and serious infectious diseases in the tropics and subtropics. For high-risk travelers to endemic regions, malaria chemoprophylaxis is recommended. Internationally, atovaquone–proguanil (A/P), mefloquine (MEF), or doxycycline (DOX) are the prescribed malari...

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Published inJournal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy Vol. 19; no. 1; pp. 20 - 23
Main Authors Kato, Tetsuro, Okuda, Joji, Ide, Daisuke, Amano, Katsushi, Takei, Yutaka, Yamaguchi, Yuko
Format Journal Article
LanguageEnglish
Published Japan Elsevier Ltd 01.02.2013
Springer Japan
Subjects
Adolescent
Adult
Aged
Antimalarials - adverse effects
Antimalarials - therapeutic use
Atovaquone - adverse effects
Atovaquone - therapeutic use
Atovaquone–proguanil
Chemoprevention
Chemoprophylaxis
Child
Drug Combinations
Female
Hematology, Oncology and Palliative Medicine
Humans
Infectious Diseases
Japan
Japanese travelers
Malaria
Malaria - prevention & control
Male
Medical Microbiology
Medicine
Medicine & Public Health
Mefloquine
Mefloquine - adverse effects
Mefloquine - therapeutic use
Middle Aged
Original Article
Proguanil - adverse effects
Proguanil - therapeutic use
Surveys and Questionnaires
Tolerability
Travel
Virology
Young Adult
Japan
Chemoprophylaxis
Tolerability
Mefloquine
Malaria
Atovaquone–proguanil
Japanese travelers
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Abstract Abstract Malaria is one of the most common and serious infectious diseases in the tropics and subtropics. For high-risk travelers to endemic regions, malaria chemoprophylaxis is recommended. Internationally, atovaquone–proguanil (A/P), mefloquine (MEF), or doxycycline (DOX) are the prescribed malaria chemoprophylactic drugs. However, A/P and DOX are not approved in Japan. Therefore, the data on A/P for malaria chemoprophylaxis in Japanese travelers are not clear. We analyzed questionnaire survey data obtained in Hibiya Clinic to assess the safety and tolerability of A/P and compare them with those of MEF for non-immune Japanese travelers. A/P was given to 278 travelers and MEF to 38 travelers. The mean duration of each prophylaxis is for 20.0 ± 9.6 and 59.0 ± 15.9 days, respectively. Nine travelers discontinued prophylaxis: 5 in the A/P prescribed group (A/P group) and 4 in the MEF prescribed group (MEF group), and the rate of discontinuation was significantly less in the A/P group. The frequency of adverse events was significantly less in the A/P group than in the MEF group [52 cases (18.8 %) vs. 14 cases (36.8 %), respectively]. In particular, the frequency of psychoneurotic adverse events was significantly less in the A/P group. These results suggest that A/P is better tolerated and has fewer adverse events than MEF in non-immune Japanese travelers.
AbstractList Malaria is one of the most common and serious infectious diseases in the tropics and subtropics. For high-risk travelers to endemic regions, malaria chemoprophylaxis is recommended. Internationally, atovaquone–proguanil (A/P), mefloquine (MEF), or doxycycline (DOX) are the prescribed malaria chemoprophylactic drugs. However, A/P and DOX are not approved in Japan. Therefore, the data on A/P for malaria chemoprophylaxis in Japanese travelers are not clear. We analyzed questionnaire survey data obtained in Hibiya Clinic to assess the safety and tolerability of A/P and compare them with those of MEF for non-immune Japanese travelers. A/P was given to 278 travelers and MEF to 38 travelers. The mean duration of each prophylaxis is for 20.0 ± 9.6 and 59.0 ± 15.9 days, respectively. Nine travelers discontinued prophylaxis: 5 in the A/P prescribed group (A/P group) and 4 in the MEF prescribed group (MEF group), and the rate of discontinuation was significantly less in the A/P group. The frequency of adverse events was significantly less in the A/P group than in the MEF group [52 cases (18.8 %) vs. 14 cases (36.8 %), respectively]. In particular, the frequency of psychoneurotic adverse events was significantly less in the A/P group. These results suggest that A/P is better tolerated and has fewer adverse events than MEF in non-immune Japanese travelers.
Malaria is one of the most common and serious infectious diseases in the tropics and subtropics. For high-risk travelers to endemic regions, malaria chemoprophylaxis is recommended. Internationally, atovaquone-proguanil (A/P), mefloquine (MEF), or doxycycline (DOX) are the prescribed malaria chemoprophylactic drugs. However, A/P and DOX are not approved in Japan. Therefore, the data on A/P for malaria chemoprophylaxis in Japanese travelers are not clear. We analyzed questionnaire survey data obtained in Hibiya Clinic to assess the safety and tolerability of A/P and compare them with those of MEF for non-immune Japanese travelers. A/P was given to 278 travelers and MEF to 38 travelers. The mean duration of each prophylaxis is for 20.0 ± 9.6 and 59.0 ± 15.9 days, respectively. Nine travelers discontinued prophylaxis: 5 in the A/P prescribed group (A/P group) and 4 in the MEF prescribed group (MEF group), and the rate of discontinuation was significantly less in the A/P group. The frequency of adverse events was significantly less in the A/P group than in the MEF group [52 cases (18.8 %) vs. 14 cases (36.8 %), respectively]. In particular, the frequency of psychoneurotic adverse events was significantly less in the A/P group. These results suggest that A/P is better tolerated and has fewer adverse events than MEF in non-immune Japanese travelers.
Abstract Malaria is one of the most common and serious infectious diseases in the tropics and subtropics. For high-risk travelers to endemic regions, malaria chemoprophylaxis is recommended. Internationally, atovaquone–proguanil (A/P), mefloquine (MEF), or doxycycline (DOX) are the prescribed malaria chemoprophylactic drugs. However, A/P and DOX are not approved in Japan. Therefore, the data on A/P for malaria chemoprophylaxis in Japanese travelers are not clear. We analyzed questionnaire survey data obtained in Hibiya Clinic to assess the safety and tolerability of A/P and compare them with those of MEF for non-immune Japanese travelers. A/P was given to 278 travelers and MEF to 38 travelers. The mean duration of each prophylaxis is for 20.0 ± 9.6 and 59.0 ± 15.9 days, respectively. Nine travelers discontinued prophylaxis: 5 in the A/P prescribed group (A/P group) and 4 in the MEF prescribed group (MEF group), and the rate of discontinuation was significantly less in the A/P group. The frequency of adverse events was significantly less in the A/P group than in the MEF group [52 cases (18.8 %) vs. 14 cases (36.8 %), respectively]. In particular, the frequency of psychoneurotic adverse events was significantly less in the A/P group. These results suggest that A/P is better tolerated and has fewer adverse events than MEF in non-immune Japanese travelers.
Malaria is one of the most common and serious infectious diseases in the tropics and subtropics. For high-risk travelers to endemic regions, malaria chemoprophylaxis is recommended. Internationally, atovaquone–proguanil (A/P), mefloquine (MEF), or doxycycline (DOX) are the prescribed malaria chemoprophylactic drugs. However, A/P and DOX are not approved in Japan. Therefore, the data on A/P for malaria chemoprophylaxis in Japanese travelers are not clear. We analyzed questionnaire survey data obtained in Hibiya Clinic to assess the safety and tolerability of A/P and compare them with those of MEF for non-immune Japanese travelers. A/P was given to 278 travelers and MEF to 38 travelers. The mean duration of each prophylaxis is for 20.0±9.6 and 59.0±15.9 days, respectively. Nine travelers discontinued prophylaxis: 5 in the A/P prescribed group (A/P group) and 4 in the MEF prescribed group (MEF group), and the rate of discontinuation was significantly less in the A/P group. The frequency of adverse events was significantly less in the A/P group than in the MEF group [52 cases (18.8 %) vs. 14 cases (36.8 %), respectively]. In particular, the frequency of psychoneurotic adverse events was significantly less in the A/P group. These results suggest that A/P is better tolerated and has fewer adverse events than MEF in non-immune Japanese travelers.
Author Ide, Daisuke
Takei, Yutaka
Kato, Tetsuro
Amano, Katsushi
Okuda, Joji
Yamaguchi, Yuko
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Keywords Chemoprophylaxis
Tolerability
Mefloquine
Malaria
Atovaquone–proguanil
Japanese travelers
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PublicationSubtitle Official Journal of the Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases
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Snippet Abstract Malaria is one of the most common and serious infectious diseases in the tropics and subtropics. For high-risk travelers to endemic regions, malaria...
Malaria is one of the most common and serious infectious diseases in the tropics and subtropics. For high-risk travelers to endemic regions, malaria...
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SubjectTerms Adolescent
Adult
Aged
Antimalarials - adverse effects
Antimalarials - therapeutic use
Atovaquone - adverse effects
Atovaquone - therapeutic use
Atovaquone–proguanil
Chemoprevention
Chemoprophylaxis
Child
Drug Combinations
Female
Hematology, Oncology and Palliative Medicine
Humans
Infectious Diseases
Japan
Japanese travelers
Malaria
Malaria - prevention & control
Male
Medical Microbiology
Medicine
Medicine & Public Health
Mefloquine
Mefloquine - adverse effects
Mefloquine - therapeutic use
Middle Aged
Original Article
Proguanil - adverse effects
Proguanil - therapeutic use
Surveys and Questionnaires
Tolerability
Travel
Virology
Young Adult
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Title Questionnaire-based analysis of atovaquone–proguanil compared with mefloquine in the chemoprophylaxis of malaria in non-immune Japanese travelers
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