Failure of Artesunate-Mefloquine Therapy for Malaria in Cambodia
Author Information
Author(s): William O. Rogers, Sem Rithy, Tero Thong, Chim Pheaktra, Lim Pharath, Muth Sinuon, Socheat Duong, Ariey Frédéric, Wongsrichanalai Chansuda
Primary Institution: Naval Medical Research Unit #2
Hypothesis
Is the artesunate-mefloquine combination therapy effective against uncomplicated Plasmodium falciparum malaria in southern Cambodia?
Conclusion
The study suggests that artesunate-mefloquine combination therapy is beginning to fail in southern Cambodia, indicating emerging resistance.
Supporting Evidence
- 47% of subjects were still parasitemic on day 2.
- 13.1% treatment failure rate at day 28.
- 18.8% treatment failure rate at day 42.
- Treatment failure associated with increased pfmdr1 copy number.
- Higher initial parasitaemia linked to treatment failure.
Takeaway
The medicines used to treat malaria in Cambodia are not working as well as they used to, which is a big problem for people getting sick.
Methodology
151 subjects with uncomplicated falciparum malaria received artesunate and mefloquine, followed for 42 days to assess treatment failure.
Potential Biases
Possible bias from unrecorded anti-malarial drug use during follow-up.
Limitations
The study may underestimate treatment failure rates due to PCR correction and potential unrecorded use of non-study anti-malarial drugs.
Participant Demographics
Majority male (93.4%), average age 27.1 years for P. falciparum subjects.
Statistical Information
P-Value
0.003
Confidence Interval
(8.5, 19.7)
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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