Mefloquine prophylaxis prevents malaria during pregnancy: a double-blind, placebo-controlled study.

Abstract

A double-blind, placebo-controlled study of mefloquine antimalarial prophylaxis in pregnancy (> 20 weeks of gestation) was conducted in 339 Karen women living in an area of multidrug-resistant malaria transmission on the Thai-Burmese border. Mefloquine gave > or = 86% (95% confidence interval [CI], 59%-94%) protection against Plasmodium falciparum and complete protection against Plasmodium vivax infections. Mefloquine prophylaxis was well tolerated; use of an initial loading dose (10 mg/kg) was associated with transient dizziness, but there were no other significant adverse effects on the mother, the pregnancy, or infant survival or development (followed for 2 years). Falciparum malaria was associated with maternal anemia and a mean reduction in birth weight in gravidae I, II, and III of 225 g (95% CI, 26-423). Maternal anemia at delivery (hematocrit < 30%) was associated with increased infant mortality: 26% versus 15% (relative risk, 1.9; 95% CI, 1.1-3.2). Mefloquine is safe and effective for antimalarial prophylaxis in the second half of pregnancy.

• Authors: F Nosten, F ter Kuile, L Maelankiri, T Chongsuphajaisiddhi, L Nopdonrattakoon, S Tangkitchot, E Boudreau, D Bunnag, N J White
• Journal: The Journal of infectious diseases (J Infect Dis) Vol. 169 Issue 3 Pg. 595-603 (Mar 1994) ISSN: 0022-1899 [Print] United States
• PMID: 8158032 (Publication Type: Clinical Trial, Controlled Clinical Trial, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Mefloquine

Topics

• Adult
• Anemia (prevention & control)
• Double-Blind Method
• Drug Resistance
• Female
• Follow-Up Studies
• Humans
• Infant, Newborn
• Malaria (physiopathology, prevention & control)
• Malaria, Falciparum (prevention & control)
• Malaria, Vivax (prevention & control)
• Mefloquine (adverse effects, therapeutic use)
• Myanmar (epidemiology)
• Outcome Assessment, Health Care
• Placenta (parasitology)
• Pregnancy
• Pregnancy Complications, Parasitic (prevention & control)
• Thailand (epidemiology)