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Efficacy of monthly tafenoquine for prophylaxis of Plasmodium vivax and multidrug-resistant P. falciparum malaria
Authors:Walsh Douglas S  Eamsila Chirapa  Sasiprapha Theerayuth  Sangkharomya Suebpong  Khaewsathien Pradith  Supakalin Panpaka  Tang Douglas B  Jarasrumgsichol Phongsak  Cherdchu Chainarong  Edstein Michael D  Rieckmann Karl H  Brewer Thomas G
Institution:Department of Immunology and Medicine, United States Army Medical Component, Bangkok, Thailand. douglas.walsh@se.amedd.army.mil.
Abstract:We assessed monthly doses of tafenoquine for preventing Plasmodium vivax and multidrug-resistant P. falciparum malaria. In a randomized, double-blind, placebo-controlled study, 205 Thai soldiers received either a loading dose of tafenoquine 400 mg (base) daily for 3 days, followed by single monthly 400-mg doses (n = 104), or placebo (n = 101), for up to 5 consecutive months. In volunteers completing follow-up (96 tafenoquine and 91 placebo recipients), there were 22 P. vivax, 8 P. falciparum, and 1 mixed infection. All infections except 1 P. vivax occurred in placebo recipients, giving tafenoquine a protective efficacy of 97% for all malaria (95% confidence interval CI], 82%-99%), 96% for P. vivax malaria (95% CI, 76%-99%), and 100% for P. falciparum malaria (95% CI, 60%-100%). Monthly tafenoquine was safe, well tolerated, and highly effective in preventing P. vivax and multidrug-resistant P. falciparum malaria in Thai soldiers during 6 months of prophylaxis.
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