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Ookluc: A Plasmodium berghei Line for Identifying Transmission-blocking Compounds
Published on: July 11, 2025
Drugs for preventing malaria in travellers
Frederique A Jacquerioz1, Ashley M Croft
1Center for Evidence-Based Global Health, Tulane School of Public Health and Tropical Medicine, 1440 Canal Street, TDW, Ste 1820, New Orleans, Louisiana, USA, 70115.
The Cochrane Database of Systematic Reviews
|October 13, 2009
Summary
Atovaquone-proguanil and doxycycline are well-tolerated antimalaria drugs for travelers, offering better safety profiles than mefloquine. Mefloquine use is linked to adverse neuropsychiatric effects, making it a less favorable choice for malaria prevention.
Area of Science:
- Travel Medicine
- Infectious Diseases
- Pharmacology
Background:
- Malaria affects 10,000-30,000 international travelers annually.
- Prevention includes mosquito control and drug prophylaxis.
- Antimalaria drugs can cause serious adverse effects.
Purpose of the Study:
- Compare efficacy, safety, and tolerability of antimalaria drugs for travelers.
- Focus on regions with Plasmodium falciparum resistance to chloroquine.
- Evaluate atovaquone-proguanil, doxycycline, and mefloquine against each other and other regimens.
Main Methods:
- Systematic review of randomized and quasi-randomized controlled trials.
- Searched multiple databases (Cochrane, MEDLINE, EMBASE, etc.) and reference lists.
- Extracted data independently, assessed risk of bias, and combined outcomes using risk ratios and mean differences.
Main Results:
- Atovaquone-proguanil and doxycycline showed similar adverse events.
- Atovaquone-proguanil had fewer adverse effects than mefloquine, including neuropsychiatric events.
- Doxycycline also had fewer neuropsychiatric events than mefloquine.
- Chloroquine-proguanil had more adverse and gastrointestinal effects compared to the other three.
Conclusions:
- Atovaquone-proguanil and doxycycline are the best-tolerated antimalaria prophylaxis regimens.
- Mefloquine is associated with adverse neuropsychiatric outcomes.
- These findings guide drug selection for malaria prevention in travelers.
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