Myanmar Health Sciences Research Journal
Volume 12, Number 1-3
TITLE: A double blind comparative trail of two dosage regimens of artesunate suppository in combinations with oral mefloquine in severe falciparum malaria.
AUTHOR: Malar Than; Zay Soe; Aung Zaw Oo; Aye Yu Soe; Kyi Kyi Tin; Khin Nyo; Myat Phone Kyaw
SOURCE: Myanmar Health Sciences Research Journal. 2000; 12(1-3): 41-47
ABSTRACT: To confirm the usefulness of artesunate suppositories (PlasmotrimTM rectocaps) in severe falciparum malaria, including patients in un-rousabfe coma, a prospective double blind randomized controlled study was carried out at the Clinical Research Unit (Malaria), DSGH, Mingaladon and at No. 1 Military Hospital (300-Bedded), Myitkyina, between May 1998 to April 2000. A total of 100 patients with severe falciparum malaria (WHO definition) with positive asexual parasitaemia in the peripheral blood film, were assigned to two dosage regimens. In regimen 1 - 55 patients received 1200 mg of artesunate (6 rectocaps) over 3 days. In regimen 2 - 45 patients received 800 mg of artesunate (4 rectocaps) over 3 days. Oral mefloquine 1250 mg in two divided doses was given on the fourth day in both regimens. Numbers of patients with cerebral malaria were 33 and 25 respectively in regimen 1 and 2. Results: Parasite clearance times were 59.32 Ã‚Â± 27.5 and 50.4 Ã‚Â± 28.2 hours, fever clearance times were 34.6 Ã‚Â± 46.0 and 33.83 Ã‚Â± 39.44 hours, mortality rates were 7.2% and 2.2% and 28 day cure-rates were 100% and 91.1% respectively in regimen 1 and 2. Patients' compliance was satisfactory and there were no serious adverse effects. Conclusion: Artesunate suppositories are well tolerated, rapidly clear parasites in severe falciparum malaria and are effective even at a low dosage of 800 mg given over 3 days. The addition of mefloquine ensures satisfactory 28-day cure-rates.
SUBJECT HEADINGS: Mefloquine. Malaria, Falciparum. Clinical Trial.