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Treatment of imported malaria in adults: a multicentre study in France

Authors :: Ranque, S.
Marchou, B.
Malvy, D.
Adehossi, E.
Laganier, R.
Tissot-Dupont, H.
Lotte, A.
Dydymsky, S.
Durant, J.
Stahl, J.-P.
Bosseray, A.
Gaillat, J.
Sotto, A.
Cazorla, C.
Ragneau, J.-M.
Brouqui, P.
Delmont, J.
Group, for the Infectio-Sud
Source :: QJM: An International Journal of Medicine; October 2005, Vol. 98 Issue: 10 p737-737, 1p
Publication Year :: 2005
Abstract: Background: Data about anti-malarial drugs prescription practices in Europe and the safety of imported malaria treatments are scanty. In 1999, a French consensus development conference published guidelines for the prevention and treatment of imported P.</it> falciparum</it> malaria. The impact of these guidelines has not been evaluated. Aim: To investigate the impact of these guidelines on the prescription of anti-malarials, and to evaluate the incidence of acute drug events (ADEs) leading to discontinuation of treatment. Design: Cross-sectional survey. Methods: Members of the medical staff in 14 French infectious and tropical disease wards completed a standardized form for each patient treated for imported malaria in 2001. A propensity score matching technique was used to estimate the risk of ADEs leading to discontinuation of the regimen. Results: In the 474 patients studied, quinine was the first-line anti-malarial most often prescribed. Only 3% of patients received halofantrine. Mefloquine was associated with a RR of 4.9 (95%CI 3.2–7.4, p</it><0.00001) risk of discontinuation of treatment due to ADEs. Discussion: The very limited use of halofantrine indicates that the main practice recommendations of the guidelines have been taken into account. Mefloquine was associated with a substantial risk of discontinuing the treatment because of ADEs. This is a serious limitation for the use of mefloquine in the treatment of out-patients with imported malaria.