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1
Centers for Disease Control and Prevention, 2005. Health Information for International Travel, 2005–2006. Atlanta, GA: US Department of Health and Human Service, Public Health Service.
-
2
Schwartz E, Parise M, Kozarsky P, Cetron M, 2003. Delayed onset of malaria—implications for chemoprophylaxis in travelers. N Engl J Med 349 :1510–1516.
-
3
Centers for Disease Control and Prevention, 2006. Malaria surveillance—United States, 2004. MMWR 55 :23–37.
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4
Baird JK, Fryauff DJ, Hoffman SL, 2003. Primaquine for prevention of malaria in travelers. Clin Infect Dis 37 :1659–1667.
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5
Hill DR, Baird JK, Parise ME, Lewis LS, Ryan ET, Magill AJ, 2006. Primaquine: Report from CDC expert meeting on malaria chemoprophylaxis I. Am J Trop Med Hyg 75 :402–415.
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6
2005. Thomas Fleming, ed. Drug Topics Red Book, 2005. Montvale, NJ: Thompson Physicians Desk Reference.
-
7
Schagenhauf P, Tschopp A, Johnson R, Northdruft HD, Beck B, Schwartz E, Herold M, Krebs B, Veit O, Allwinn R, Steffen R, 2003. Tolerability of malaria chemoprophylaxis in non-immune travelers to sub-Saharan Africa: Multicentre, randomized, double blind, four-arm study. BMJ 327 :1078–1084.
-
8
Newton JA, Schnepf GA, Wallace MR, Lobel HO, Kennedy CA, Oldfield EC, 1994. Malaria in US Marines returning from Somalia. JAMA 272 :397–399.
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9
Kotwal RS, Wenzel RB, Sterling RA, Porter WD, Jordan NN, Petruccelli BP, 2005. An outbreak of malaria in US Army Rangers returning from Afghanistan. JAMA 293 :212–216.
-
10
Taylor WR, White NJ, 2004. Antimalarial drug toxicity: A review. Drug Saf 27 :25–61.
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11
Van Riemsdijk MM, Stureenboom MC, Ditters JM, Tulen JH, Ligthelm RJ, Overbosch D, Stricker BH, 2004. Low body mass index is associated with an increased risk of neuropsychiatric adverse events and concentration impairment in women on mefloquine. Br J Clin Pharmacol 57 :506–512.
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12
Emberger M, Lechner AM, Zelger B, 2003. Stevens-Johnson syndrome associated with Malarone antimalarial prophylaxis. Clin Infect Dis 37 :e5–e7.
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13
Farnert A, Lindberg J, Gil P, Swedberg G, Berqvist Y, Thapar MM, Lindegardh N, Berezcky S, Bjorkman A, 2003. Evidence of Plasmodium falciparum malaria resistant to atovaquone and proguanil hydrochloride: case reports. BMJ 326 :628–629.
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14
Kitchener SJ, Nasveld PE, Gregory RM, Edstein MD, 2005. Mefloquine and doxycycline malaria prophylaxis in Australian soldiers in East Timor. Med J Aust 182 :168–171.
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COST CONSIDERATIONS OF MALARIA CHEMOPROPHYLAXIS INCLUDING USE OF PRIMAQUINE FOR PRIMARY OR TERMINAL CHEMOPROPHYLAXIS
JOE P. BRYAN
JOE P. BRYAN
Office of Medical Services, Department of State, Washington, DC
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The costs of mefloquine, chloroquine, doxycycline, primaquine, and atovaquone/proguanil are calculated for various durations of exposure to malaria. The cost is included for detecting glucose 6-phosphate dehydrogenase (G6PD) deficiency before administering primaquine for primary or terminal prophylaxis. For durations of exposure ranging from 3 to 730 days, if no terminal prophylaxis is given, doxycycline (generic) is the least expensive regimen. Compared with doxycycline hyclate, chloroquine costs three to four times more, and primaquine, after screening for G6PD, costs about eight times more. Atovaquone/proguanil is less expensive than mefloquine for a 3-day exposure, but more expensive for 7 or more days. When terminal chemoprophylaxis with primaquine for 14 days is used in addition to doxycycline, mefloquine, chloroquine, or atovaquone/proguanil, primaquine alone is the least expensive regimen for exposures of < 10 days. Thereafter, doxycycline plus 14 days of primaquine is most economical. For subsequent exposures when G6PD status is already known, primaquine alone is the least expensive regimen for up to 9 days of exposure, but doxycycline is less expensive thereafter. In general, generic doxycycline hyclate is the least expensive regimen. Primaquine alone is economically attractive. Mefloquine, doxycyline monohydrate, and atovaquone/proguanil, the most expensive regimens, are similar in cost for a 7-day exposure, but thereafter, atovaquone/proguanil is much more expensive.
Author Notes
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RefWorks
Reference Manager
BibTeX
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-
1
Centers for Disease Control and Prevention, 2005. Health Information for International Travel, 2005–2006. Atlanta, GA: US Department of Health and Human Service, Public Health Service.
-
2
Schwartz E, Parise M, Kozarsky P, Cetron M, 2003. Delayed onset of malaria—implications for chemoprophylaxis in travelers. N Engl J Med 349 :1510–1516.
-
3
Centers for Disease Control and Prevention, 2006. Malaria surveillance—United States, 2004. MMWR 55 :23–37.
-
4
Baird JK, Fryauff DJ, Hoffman SL, 2003. Primaquine for prevention of malaria in travelers. Clin Infect Dis 37 :1659–1667.
-
5
Hill DR, Baird JK, Parise ME, Lewis LS, Ryan ET, Magill AJ, 2006. Primaquine: Report from CDC expert meeting on malaria chemoprophylaxis I. Am J Trop Med Hyg 75 :402–415.
-
6
2005. Thomas Fleming, ed. Drug Topics Red Book, 2005. Montvale, NJ: Thompson Physicians Desk Reference.
-
7
Schagenhauf P, Tschopp A, Johnson R, Northdruft HD, Beck B, Schwartz E, Herold M, Krebs B, Veit O, Allwinn R, Steffen R, 2003. Tolerability of malaria chemoprophylaxis in non-immune travelers to sub-Saharan Africa: Multicentre, randomized, double blind, four-arm study. BMJ 327 :1078–1084.
-
8
Newton JA, Schnepf GA, Wallace MR, Lobel HO, Kennedy CA, Oldfield EC, 1994. Malaria in US Marines returning from Somalia. JAMA 272 :397–399.
-
9
Kotwal RS, Wenzel RB, Sterling RA, Porter WD, Jordan NN, Petruccelli BP, 2005. An outbreak of malaria in US Army Rangers returning from Afghanistan. JAMA 293 :212–216.
-
10
Taylor WR, White NJ, 2004. Antimalarial drug toxicity: A review. Drug Saf 27 :25–61.
-
11
Van Riemsdijk MM, Stureenboom MC, Ditters JM, Tulen JH, Ligthelm RJ, Overbosch D, Stricker BH, 2004. Low body mass index is associated with an increased risk of neuropsychiatric adverse events and concentration impairment in women on mefloquine. Br J Clin Pharmacol 57 :506–512.
-
12
Emberger M, Lechner AM, Zelger B, 2003. Stevens-Johnson syndrome associated with Malarone antimalarial prophylaxis. Clin Infect Dis 37 :e5–e7.
-
13
Farnert A, Lindberg J, Gil P, Swedberg G, Berqvist Y, Thapar MM, Lindegardh N, Berezcky S, Bjorkman A, 2003. Evidence of Plasmodium falciparum malaria resistant to atovaquone and proguanil hydrochloride: case reports. BMJ 326 :628–629.
-
14
Kitchener SJ, Nasveld PE, Gregory RM, Edstein MD, 2005. Mefloquine and doxycycline malaria prophylaxis in Australian soldiers in East Timor. Med J Aust 182 :168–171.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 757 | 672 | 213 |
| Full Text Views | 237 | 15 | 0 |
| PDF Downloads | 61 | 23 | 0 |