Methylene blue for malaria in Africa: results from a dose-finding study in combination with chloroquine.

Abstract

The development of safe, effective and affordable drug combinations against malaria in Africa is a public health priority. Methylene blue (MB) has a similar mode of action as chloroquine (CQ) and has moreover been shown to selectively inhibit the Plasmodium falciparum glutathione reductase. In 2004, an uncontrolled dose-finding study on the combination MB-CQ was performed in 435 young children with uncomplicated falciparum malaria in Burkina Faso (CQ monotherapy had a > 50% clinical failure rate in this area in 2003). Three serious adverse events (SAE) occurred of which one was probably attributable to the study medication. In the per protocol safety analysis, there were no dose specific effects. The overall clinical and parasitological failure rates by day 14 were 10% [95% CI (7.5%, 14.0%)] and 24% [95% CI (19.4%, 28.3%)], respectively. MB appears to have efficacy against malaria, but the combination of CQ-MB is clearly not effective in the treatment of malaria in Africa.

• Authors: Peter E Meissner, Germain Mandi, Boubacar Coulibaly, Steffen Witte, Théophile Tapsoba, Ulrich Mansmann, Jens Rengelshausen, Wolfgang Schiek, Albrecht Jahn, Ingeborg Walter-Sack, Gerd Mikus, Jürgen Burhenne, Klaus-Dieter Riedel, R Heiner Schirmer, Bocar Kouyaté, Olaf Müller
• Journal: Malaria journal (Malar J) Vol. 5 Pg. 84 (Oct 08 2006) ISSN: 1475-2875 [Electronic] England
• PMID: 17026773 (Publication Type: Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Chloroquine
• Methylene Blue

Topics

• Burkina Faso (epidemiology)
• Child, Preschool
• Chloroquine (administration & dosage, adverse effects, therapeutic use)
• Dose-Response Relationship, Drug
• Drug Therapy, Combination
• Female
• Humans
• Infant
• Malaria, Falciparum (drug therapy, epidemiology)
• Male
• Methylene Blue (administration & dosage, adverse effects, therapeutic use)
• Random Allocation
• Treatment Failure