Estudo da eficácia e tolerância do artesunato oral isolado e em associação com mefloquina, no tratamento da malária falciparum não complicada em área endêmica do Pará, Brasil

Abstract

With the objective to evaluate the efficacy and tolerance of artesunate in the treatment of noncomplicated falciparum malaria in endemic area of the State of Pará, 153 patients were randomized and studied in three groups, distributed by therapeutical scheme (I received mefloquine 1000 mg, II used artesunate 600 mg followed by mefloquine 500 mg). Evaluation was made by daily clinical and parasitological examination, in the first 7 days, and weekly until the 35th day of the follow-up. Biochemical and hematological analysts previously done and on the 7th day, targeting cure control and identification of possible effects related to drugs administration. As to sex, parasitemia and fever, studied groups were homogeneous. Time for parasitemia disappearance was shorter in the groups II and III respectively, whose therapeutical schemes had artesunate. Fever disappearance was quicker in the group treated with the combination of drugs. Clinical and biochemical alterations associated with drugs administration did not show significant differences among the studied groups. Early disappearance of fever and parasitemia, and absence of important side effects suggest that artesunate, isolated or administrated in combination with mefloquine, constitutes an able therapeutical procedure to constitutes and able therapeutical procedure to contribute for disease control in that region.

Efficacy of Mefloquine and a Mefloquine-Artesunate Combination Therapy for the Treatment of Uncomplicated Plasmodium Falciparum Malaria in the Amazon Basin of Peru

“…6 Although in vitro resistance to MQ has been reported from this area since the early 1980s, 7 only recently have a small number of well-documented cases of RI in vivo resistance to a single dose of 15 mg/kg been recorded. 8,9 In this trial in the Peruvian Amazon region, we found no evidence of resistance to either MQ or MQ-AS; however, at the time the …”

In Vivo Efficacy of Mefloquine for the Treatment of Falciparum Malaria in Brazil

“…After the completion of our work (1996-1997), Cardoso et al [7] published a study of subjects from the Amazon region who had been treated with similar mg/kg doses of mefloquine during 1993-1994, in which they also found a 100% cure rate, although they examined a lower number of fields per thick smear.…”

“…The credibility of such programs depends on a high mefloquine efficacy. Although there seem to be no published reports of widespread mefloquine resistance in Brazil [5][6][7], periodic clinical trials should be conducted to monitor its efficacy, especially because of the possibility of mefloquine cross-resistance with quinine [8]. When we initiated this study, there had been no reported clinical studies of mefloquine in Brazil for over a decade, during which time mefloquine resistance rose dramatically in Southeast Asia [9].…”

Efficacy of Chloroquine, Sulfadoxine-Pyrimethamine, and Mefloquine for the Treatment of Uncomplicated Plasmodium Falciparum Malaria on the North Coast of Peru

“…In vitro resistance to MQ has been reported for several years from the Brazilian Amazon region, 14 but its clinical significance has been ques-tioned since only recently have well-documented cases of in vivo resistance (RI) to 15 mg/kg MQ been recorded. 15,16 MQ resistance has not been reported from other countries in the region. If MQ-resistant strains do occur in Peru, they probably would be found in the Amazon region and might easily be missed in a trial with only 14-day follow-up.…”