Compliance with a Three-Day Course of Artesunate-Mefloquine Combination in an Area of Thailand with Highly Multidrug Resistant Falciparum Malaria

Abstract

The compliance of a three-day course of artesunate (ARS)-mefloquine (MQ) (4
mg/kg body weight ARS once daily for three consecutive days, plus 15 and 10 mg/kg body
weight MQ on the first and second days) was evaluated in a total of 240 patients (196 males
and 44 females) who were attending the malaria clinics in Mae-Sot, Tak Province and
presenting with symptomatic acute uncomplicated Plasmodium falciparum malaria. The
gametocytocydal anti-malarial drug primaquine (PQ) is administered at the dose of 30 mg
(0.6 mg/kg) on the last day. The first dose of the treatment was given to the patients under
direct supervision. All patients were given the medication for self-treatment at home and
were requested to come back for follow-up on day 3 of the initial treatment. The Kaplan-
Meier estimate of the 42-day efficacy rate of this combination regimen was 99.2% (238/240).
A three-day combination regimen of ARS-MQ provides excellent patient compliance with
good efficacy and tolerability in the treatment of highly multidrug resistance falciparum
malaria Based on whole blood MQ and plasma PQ concentrations on day 3 of the initial
treatment, compliance with MQ and PQ in this three-day ARS-MQ combination regimen
were 96.3% (207/215), and 98.5% (197/200), respectively.