SINGLE-DOSE ARTEMISININ-MEFLOQUINE VERSUS MEFLOQUINE ALONE FOR UNCOMPLICATED FALCIPARUM-MALARIA

The efficacy of the combination of a single oral dose of 500 mg artemi sinin with a single 500 mg oral dose of mefloquine (AM) in the treatme nt of uncomplicated falciparum malaria was compared to mefloquine ther apy alone (M) in a double-'blind' randomized study in an endemic area in the south of Viet Nam where single low dose treatment was employed and where mefloquine had been recently introduced. 231 patients, 117 A M and 114 M, were studied. Failure of therapy occurred in 1 AM patient and in 3 M patients. The radical cure rate was 84% for the AM regimen and 65% for the M regimen (P=0.002). Recrudescence (including an unkn own percentage of reinfections) occurred in 15% of AM patients and in 30% of M patients (P=0.01). The mean parasite clearance time was 40 h (SD=16) for AM and 60 h (SD=27) for the M regimen (P=0.0001). No effec t of artemisinin was noted on gametocytes present on admission, but ne w gametocytes developed less frequently in the AM group The addition o f a single dose of 500 mg artemisinin to 500 mg mefloquine increased t he efficacy and reduced the rate of recrudescence, but this regimen wa s not adequate and, for short course regimens, more doses of artemisin in as well as higher doses of mefloquine should be studied.