EFFECTIVENESS OF QUININE MONOTHERAPY FOR THE TREATMENT OF PLASMODIUM FALCIPARUM INFECTION IN PREGNANT WOMEN IN LAMBARÉNÉ, GABON

AYÔLA A. ADEGNIKA Medical Research Unit, Albert Schweitzer Hospital, Lambaréné, Gabon; Institute for Tropical Medicine, Department of Parasitology, University of Tübingen, Tübingen, Germany; Department of Internal Medicine I, Division of Infectious Diseases, Medical University of Vienna, Vienna, Austria

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LUTZ PH. BREITLING Medical Research Unit, Albert Schweitzer Hospital, Lambaréné, Gabon; Institute for Tropical Medicine, Department of Parasitology, University of Tübingen, Tübingen, Germany; Department of Internal Medicine I, Division of Infectious Diseases, Medical University of Vienna, Vienna, Austria

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SELIDJI T. AGNANDJI Medical Research Unit, Albert Schweitzer Hospital, Lambaréné, Gabon; Institute for Tropical Medicine, Department of Parasitology, University of Tübingen, Tübingen, Germany; Department of Internal Medicine I, Division of Infectious Diseases, Medical University of Vienna, Vienna, Austria

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SANDERS K. CHAI Medical Research Unit, Albert Schweitzer Hospital, Lambaréné, Gabon; Institute for Tropical Medicine, Department of Parasitology, University of Tübingen, Tübingen, Germany; Department of Internal Medicine I, Division of Infectious Diseases, Medical University of Vienna, Vienna, Austria

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DANIELA SCHÜTTE Medical Research Unit, Albert Schweitzer Hospital, Lambaréné, Gabon; Institute for Tropical Medicine, Department of Parasitology, University of Tübingen, Tübingen, Germany; Department of Internal Medicine I, Division of Infectious Diseases, Medical University of Vienna, Vienna, Austria

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SUNNY OYAKHIROME Medical Research Unit, Albert Schweitzer Hospital, Lambaréné, Gabon; Institute for Tropical Medicine, Department of Parasitology, University of Tübingen, Tübingen, Germany; Department of Internal Medicine I, Division of Infectious Diseases, Medical University of Vienna, Vienna, Austria

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NORBERT G. SCHWARZ Medical Research Unit, Albert Schweitzer Hospital, Lambaréné, Gabon; Institute for Tropical Medicine, Department of Parasitology, University of Tübingen, Tübingen, Germany; Department of Internal Medicine I, Division of Infectious Diseases, Medical University of Vienna, Vienna, Austria

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MARTIN P. GROBUSCH Medical Research Unit, Albert Schweitzer Hospital, Lambaréné, Gabon; Institute for Tropical Medicine, Department of Parasitology, University of Tübingen, Tübingen, Germany; Department of Internal Medicine I, Division of Infectious Diseases, Medical University of Vienna, Vienna, Austria

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MICHEL A. MISSINOU Medical Research Unit, Albert Schweitzer Hospital, Lambaréné, Gabon; Institute for Tropical Medicine, Department of Parasitology, University of Tübingen, Tübingen, Germany; Department of Internal Medicine I, Division of Infectious Diseases, Medical University of Vienna, Vienna, Austria

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MICHAEL RAMHARTER Medical Research Unit, Albert Schweitzer Hospital, Lambaréné, Gabon; Institute for Tropical Medicine, Department of Parasitology, University of Tübingen, Tübingen, Germany; Department of Internal Medicine I, Division of Infectious Diseases, Medical University of Vienna, Vienna, Austria

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SAADOU ISSIFOU Medical Research Unit, Albert Schweitzer Hospital, Lambaréné, Gabon; Institute for Tropical Medicine, Department of Parasitology, University of Tübingen, Tübingen, Germany; Department of Internal Medicine I, Division of Infectious Diseases, Medical University of Vienna, Vienna, Austria

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PETER G. KREMSNER Medical Research Unit, Albert Schweitzer Hospital, Lambaréné, Gabon; Institute for Tropical Medicine, Department of Parasitology, University of Tübingen, Tübingen, Germany; Department of Internal Medicine I, Division of Infectious Diseases, Medical University of Vienna, Vienna, Austria

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Pregnant women participating in a longitudinal immuno-epidemiologic survey in Lambaréné, Gabon, and presenting with Plasmodium falciparum 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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