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Mefloquine for uncomplicated Plasmodium falciparum malaria in children

Philippe Minodier1, Guilhem Noël, Mamadou Tall

  • 1Pediatric Emergency, CHU Nord, Chemin des Bourrelly, Marseille Cedex, France. philippe.minodier@ap-hm.fr

The Pediatric Infectious Disease Journal
|May 21, 2011
PubMed

Insights

Mefloquine effectively treats imported childhood malaria. While vomiting is common in younger children, a second dose can ensure successful treatment outcomes for Plasmodium falciparum.

Area of Science:

  • Pediatric Infectious Diseases
  • Tropical Medicine
  • Pharmacology

Background:

  • Uncomplicated Plasmodium falciparum malaria in children is treated with various antimalarials, including mefloquine.
  • Limited data exist on mefloquine's efficacy for imported malaria in pediatric populations.

Purpose of the Study:

  • To evaluate the treatment efficacy of oral mefloquine for uncomplicated imported Plasmodium falciparum malaria in children.
  • To identify factors associated with early vomiting after mefloquine administration.

Main Methods:

  • Prospective study of 95 children (3 months–16 years) treated with oral mefloquine and an antiemetic.
  • Clinical data, including travel history, symptoms, and laboratory parameters, were collected.
  • Follow-up for 45 days to assess treatment efficacy and relapse.

Main Results:

  • Mefloquine achieved initial cure in all children, with no P. falciparum relapses within 45 days.
  • Vomiting occurred within 1 hour of dosing in 20% of children, significantly associated with lower weight (≤ 15 kg).
  • Most children (94%) had traveled to the Indian Ocean region; compliance with chemoprophylaxis was low.

Conclusions:

  • Mefloquine is an effective treatment for uncomplicated imported P. falciparum malaria in children from regions with low mefloquine resistance.
  • Early vomiting is a frequent side effect, particularly in children under 15 kg, but can be managed with a second dose.
  • This highlights the importance of weight-based dosing and antiemetic co-administration.
Abstract

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