Mefloquine in the treatment of falciparum malaria during pregnancy in Eastern Sudan

Objective: To test the efficacy and toxicity of mefloquine therapy both on expectant mothers and the outcome of their pregnancies. Methods: We performed a prospective non-comparative clinical trial in New Haifa Teaching Hospital, Eastern Sudan, during the period October 1998 to June 2001. Pregnant Sudanese women were given mefloquine 25 mg/kg for treatment of falciparum malaria following chloroquine failure. The women were followed every 2 weeks in the antenatal clinic until delivery. The babies were followed until the age of one year. Results: Forty pregnant women were enrolled in the second and third trimesters. Itching which occurred in 17.5% and nausea which occurred in 35% were the cardinal side effects of the patients. Recrudescence or re-infection occurred on day 14 in one patient (2.5%). One patient that received mefloquine at 34 weeks gestational age delivered low birth weight (2.1 kg) at 39 weeks gestational age. One child died at the age of 7 months due to unexplained febrile illness. There was no abortion, no stillbirth and no congenital abnormality in the newborn children and no maternal death. Conclusion: This relatively small study reported that mefloquine could be used safely for the treatment of malaria in the second and third trimester of pregnancy and a larger study is recommended.