Volume 73, Issue 2
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645


Pregnant women participating in a longitudinal immuno-epidemiologic survey in Lambaréné, Gabon, and presenting with parasitemia at monthly blood smear examinations were offered treatment with oral 7-day quinine monotherapy according to national health guidelines. A total of 50 pregnant women were offered 7-day oral quinine sulfate 10 mg/kg thrice daily. Clinical examinations and laboratory tests were performed on Days 28 and 56 to assess the effectiveness of this standard regimen. By Day 28, the effectiveness of the 7-day quinine regimen was 60% (95% confidence interval: 46–72%). We conclude that a 7-day course of quinine has a poor effectiveness and that alternative treatment regimens for malaria in pregnant women should be assessed.


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  1. Newman RD, Parise ME, Slutsker L, Nahlen B, Steketee RW, 2003. Safety, efficacy and determinants of effectiveness of antimalarial drugs during pregnancy: implications for prevention programmes in Plasmodium falciparum-endemic sub-Saharan Africa. Trop. Med Int Health 8 : 488–506. [Google Scholar]
  2. Steketee RW, Wirima JJ, Slutsker L, Heymann DL, Breman JG, 1996. The problem of malaria and malaria control in pregnancy in sub-Saharan Africa. Am J Trop Med Hyg 55 : 2–7. [Google Scholar]
  3. Verhoeff FH, Brabin BJ, Chimsuku L, Kazembe P, Russell WB, Broadhead RL, 1998. An evaluation of the effects of intermittent sulfadoxine-pyrimethamine treatment in pregnancy on parasite clearance and risk of low birthweight in rural Malawi. Ann Trop Med Parasitol 92 : 141–150. [Google Scholar]
  4. Karbwang J, Harinasuta T, 1992. Overview: clinical pharmacology of antimalarials. Southeast Asian J Trop Med Public Health 4 : 95–109. [Google Scholar]
  5. van Eijk AM, Ayisi JG, ter Kuile FO, Slutsker L, Otieno JA, Misore AO, Odondi JO, Rosen DH, Kager PA, Steketee RW, Nahlen BL, 2004. Implementation of intermittent preventive treatment with sulphadoxine-pyrimethamine for control of malaria in pregnancy in Kisumu, western Kenya. Trop Med Int Health 9 : 630–637. [Google Scholar]
  6. van Eijk AM, Ayisi JG, ter Kuile FO, Otieno JA, Misore AO, Odondi JO, Rosen DH, Kager PA, Steketee RW, Nahlen BL, 2004. Effectiveness of intermittent preventive treatment with sulphadoxine-pyrimethamine for control of malaria in pregnancy in western Kenya: a hospital-based study. Trop Med Int Health 9 : 351–360. [Google Scholar]
  7. Holtz TH, Kachur SP, Roberts JM, Marum LH, Mkandala C, Chizani N, Macheso A, Parise ME, 2004. Use of antenatal care services and intermittent preventive treatment for malaria among pregnant women in Blantyre District, Malawi. Trop Med Int Health 9 : 77–82. [Google Scholar]
  8. Kremsner PG, Winkler S, Brandts C, Neifer S, Bienzle U, Graninger W, 1994. Clindamycin in combination with chloroquine or quinine is an effective therapy for uncomplicated Plasmodium falciparum malaria in children from Gabon. J Infec Dis 169 : 467–470. [Google Scholar]
  9. Wildling E, Winkler S, Kremsner PG, Brandts C, Jenne L, Wernsdorfer WH, 1995. Malaria epidemiology in the province of Moyen Ogooue, Gabon. Trop Med Parasitol 46 : 77–82. [Google Scholar]
  10. Sylla EH, Lell B, Kun JF, Kremsner PG, 2001. Plasmodium falciparum transmission intensity and infection rates in children in Gabon. Parasitol Res 87 : 530–533. [Google Scholar]
  11. Borrmann S, Binder RK, Adegnika AA, Missinou MA, Issifou S, Ramharter M, Wernsdorfer WH, Kremsner PG, 2002. Reassessment of the resistance of Plasmodium falciparum to chloroquine in Gabon: implications for the validity of tests in vitro vs. in vivo. Trans R Soc Trop Med Hyg 96 : 660–663. [Google Scholar]
  12. Kremsner PG, Radloff P, Metzger W, Wildling E, Mordmuller B, Philipps J, Jenne L, Nkeyi M, Prada J, Bienzle U, 1995. Quinine plus clindamycin improves chemotherapy of severe malaria in children. Antimicrob. Agents Chemother 39 : 1603–1605. [Google Scholar]
  13. Ramharter M, Wernsdorfer WH, Kremsner PG, 2004. In vitro activity of quinolines against Plasmodium falciparum in Gabon. Acta Trop 90 : 55–60. [Google Scholar]
  14. Planche T, Krishna S, Kombila M, Engel K, Faucher JF, Ngou-Milama E, Kremsner PG, 2001. Comparison of methods for the rapid laboratory assessment of children with malaria. Am J Trop Med Hyg 65 : 599–602. [Google Scholar]
  15. Winkler S, Brandts C, Wernsdorfer WH, Graninger W, Bienzle U, Kremsne PG, 1994. Drug sensitivity of Plasmodium falciparum in Gabon. Activity correlations between various antimalarials. Trop Med Parasitol 45 : 214–218. [Google Scholar]
  16. Kun JF, Missinou MA, Lell B, Sovric M, Knoop H, Bojowald B, Dangelmaier O, Kremsner PG, 2002. New emerging Plasmodium falciparum genotypes in children during the transition phase from asymptomatic parasitemia to malaria. Am J Trop Med Hyg 66 : 653–658. [Google Scholar]
  17. Staalsoe T, Shulman CE, Bulmer JN, Kawuondo K, Marsh K, Hviid L, 2004. Variant surface antigen-specific IgG and protection against clinical consequences of pregnancy-associated Plasmodium falciparum malaria. Lancet 363 : 283–289. [Google Scholar]
  18. Ramharter M, Grobusch MP, Kiessling G, Adegnika AA, Möller U, Agnandji ST, Kramer M, Schwartz N, Kun JFJ, Oyakhirome S, Borrmann S, Lell B, Mordmüller B, Kremsner PG, 2005. Clinical and parasitological characteristics of Puerperal malaria. J Infect Dis. 191 : 1005–1009. [Google Scholar]
  19. Supanaranond W, Davis TM, Pukrittayakamee S, Silamut K, Karbwang J, Molunto P, Chanond L, White NJ, 1991. Disposition of oral quinine in acute falciparum malaria. Eur J Clin Pharmacol 40 : 49–52. [Google Scholar]
  20. Na-Bangchang K, Karbwang J, 1993. Clinical Pharmacology of quinine. Karbwang J, Wernsdorfer W, eds. Clinical Pharmacology of Antimalarials. Bangkok, Thailand: Faculty of Tropical Medicine, Mahidol University, 127–165.
  21. Metzger W, Mordmuller B, Graninger W, Bienzle U, Kremsner PG, 1995. High efficacy of short-term quinine-antibiotic combinations for treating adult malaria patients in an area in which malaria is hyperendemic. Antimicrob Agents Chemother 39 : 245–246. [Google Scholar]
  22. Okoko BJ, Enwere G, Ota MO, 2003. The epidemiology and consequences of maternal malaria: a review of immunological basis. Acta Trop 87 : 193–205. [Google Scholar]
  23. Yasmin S, Osrin D, Paul E, Costello A, 2001. Neonatal mortality of low-birth-weight infants in Bangladesh. Bull WHO 79 : 608–614. [Google Scholar]
  24. Myint HY, Tipmanee P, Nosten F, Day NP, Pukrittayakamee S, Looareesuwan S, White NJ, 2004. A systematic overview of published antimalarial drug trials. Trans R Soc Trop Med Hyg 98 : 73–81. [Google Scholar]

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  • Received : 08 Dec 2004
  • Accepted : 10 Feb 2005

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