Journal Article

Randomized, Placebo-Controlled Trial of Atovaquone/Proguanil for the Prevention of <i>Plasmodium falciparum</i> or <i>Plasmodium vivax</i> Malaria among Migrants to Papua, Indonesia

Judith Ling, J. Kevin Baird, David J. Fryauff, Priyanto Sismadi, Michael J. Bangs, Mark Lacy, Mazie J. Barcus, Robert Gramzinski, Jason D. Maguire, Marti Kumusumangsih, Gerri B. Miller, Trevor R. Jones, Jeffrey D. Chulay and Stephen L. Hoffman

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 35, issue 7, pages 825-833
Published in print October 2002 | ISSN: 1058-4838
Published online October 2002 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/342578
Randomized, Placebo-Controlled Trial of Atovaquone/Proguanil for the Prevention of Plasmodium falciparum or Plasmodium vivax Malaria among Migrants to Papua, Indonesia

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The increasing prevalence of resistance to antimalarial drugs reduces options for malaria prophylaxis. Atovaquone/proguanil (Malarone; GlaxoSmithKline) has been >95% effective in preventing Plasmodium falciparum malaria in lifelong residents of areas of holoendemicity, but data from persons without clinical immunity or who are at risk for Plasmodium vivax malaria have not been described. We conducted a randomized, double-blinded study involving 297 people from areas of nonendemicity in Indonesia who migrated to Papua (where malaria is endemic) ⩽26 months before the study period. Subjects received prophylaxis with 1 Malarone tablet (250 mg of atovaquone and 100 mg of proguanil hydrochloride; n = 148) or placebo (n = 149) per day for 20 weeks. Hematologic and clinical chemistry values did not change significantly. The protective efficacy of atovaquone/proguanil was 84% (95% confidence interval [CI], 44%–95%) for P. vivax malaria, 96% (95% CI, 72%–99%) for P. falciparum malaria, and 93% (95% CI, 77%–98%) overall. Atovaquone/proguanil was well tolerated, safe, and effective for the prevention of drug-resistant P. vivax and P. falciparum malaria in individuals without prior malaria exposure who migrated to Papua, Indonesia.

Journal Article.  4831 words.  Illustrated.

Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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