Changes in the Treatment Responses to Artesunate-Mefloquine on the Northwestern Border of Thailand during 13 Years of Continuous Deployment
2009

Changes in Malaria Treatment Responses in Thailand

Sample size: 3264 publication 10 minutes Evidence: moderate

Author Information

Author(s): Carrara Verena Ilona, Zwang Julien, Ashley Elizabeth A., Price Ric N., Stepniewska Kasia, Barends Marion, Brockman Alan, Anderson Tim, McGready Rose, Phaiphun Lucy, Proux Stephane, van Vugt Michele, Hutagalung Robert, Lwin Khin Maung, Phyo Aung Pyae, Preechapornkul Piyanuch, Imwong Mallika, Pukrittayakamee Sasithon, Singhasivanon Pratap, White Nicholas J., Nosten François

Primary Institution: Shoklo Malaria Research Unit, Tak, Thailand

Hypothesis

How has the efficacy of the artesunate-mefloquine treatment regimen changed over 13 years in Thailand?

Conclusion

Despite a slight decline in efficacy, artesunate-mefloquine remains highly effective against malaria in the region.

Supporting Evidence

  • The proportion of patients with parasitaemia persisting on day-2 increased from 4.5% before 2001 to 21.9% since 2002.
  • Delayed parasite clearance was associated with an increased risk of developing gametocytaemia.
  • The efficacy of the MAS3 regimen has declined slightly but remained above 95% in 2007.

Takeaway

Doctors have been treating malaria with a combination of two medicines for a long time, and while it still works well, it's taking a bit longer for patients to get better.

Methodology

The study involved 3,264 patients treated with a 3-day regimen of artesunate and mefloquine, monitored for treatment efficacy over 13 years.

Potential Biases

Potential biases may arise from the observational nature of the study and the specific population studied.

Limitations

The study may not fully account for all variables affecting treatment outcomes, such as patient adherence and variations in parasite strains.

Participant Demographics

36% of participants were children under 15 years, with a predominance of males (73%) among adults.

Statistical Information

P-Value

p<0.001

Confidence Interval

95% CI, 91.0–98.7

Statistical Significance

p<0.001

Digital Object Identifier (DOI)

10.1371/journal.pone.0004551

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