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Background Delivering drugs in a fixed combination is essential to the success of the strategy of artemisinin-based combination therapy. This prevents one drug being taken without the protection of the other, reducing the chance of emergence and spread of drug resistant strains of Plasmodium falciparum. A lower tablet burden should also facilitate adherence to treatment. A new fixed combination of mefloquine plus artesunate has been developed. This was compared with the conventional regimen of separate tablets for the treatment of uncomplicated multidrug-resistant falciparum malaria. Methods On the north-western border of Thailand 500 adults and children with uncomplicated falciparum malaria were randomized to receive either the new fixed combination or separate tablets. They were followed up weekly for 63 days. Results The day 63 polymerase chain reaction-adjusted cure rates were 91.9% (95% CI 88.2–95.6) in the fixed combination group and 89.2% (85.0–93.4) in the loose tablets group ( P = 0.3). There was a lower incidence of early vomiting in the group receiving the fixed combination. Conclusion This new fixed combination of mefloquine and artesunate was efficacious, well tolerated and convenient to administer. [ABSTRACT FROM AUTHOR]

Examines the performance of Paracheck-Pf for Plasmodium falciparum diagnosis. Detection of the P. falciparum specific histidine rich protein-2; Determination of parasitemia; Control of the multidrug resistant strains.

We compared the performance of Paracheck-Pf, a new and cheap rapid malaria test, with ICT-Pf/PvR and microscopy in two malaria surveys in Thai villages on the Thai-Burmese border. The specificity, sensitivity, predictive positive and negative values of the Paracheck-PfR and ICT-PfR tests were calculated taking microscopy results as the gold standard. The 294 ICT-Pf/Pv tests resulted in two invalid (no control line) and 11 doubtful results. Both the ICT-Pf/PvR and Paracheck-PfR tests reliably detected P. falciparum infections. However, Paracheck-PfR failed to detect three P. falciparum cases and likewise, ICT-Pf/PvR failed to detect the same three cases and an additional four cases. These seven cases were detected by microscopy and had a parasitaemia under 150 parasites/microl. At a cost of c. US $1.00, the Paracheck-PfR test, based on the detection of the P. falciparum specific HRP-2 protein, is a reliable, easy to use and affordable tool for the diagnosis of P. falciparum malaria. [ABSTRACT FROM AUTHOR]