{
  "abstract": "Introduction: A combination of mefloquine associated with artesunate (AS-MQ) was the first artemisinin-based combination therapy (ACT) to be used widely for acute uncomplicated P. falciparum malaria. Methods: Individual patient data from 31 studies of patients with uncomplicated falciparum malaria treated with various AS-MQ regimens (target mefloquine dose 25 mg/kg), conducted in Asia, Africa and South America, were pooled and analysed to investigate the effects of MQ mg/kg dosing on malaria recurrence and other clinical, parasitological and tolerability endpoints. Results: A total of 6,761 patients were enrolled in clinical studies conducted between 1995 and 2018; the majority (74%) were from Asia. The median age of study participants was 18 years (interquartile range IQR 8-30 years), of whom 13.5% (915/6761) were aged less than 5 years old. Participants received an estimated median [range] total mg/kg dose of mefloquine and artesunate of 25 [6.8-60] and 12 [3.6-33.3] respectively, and 1,572 (23.4%) participants were treated with the coformulation. The PCR-corrected recrudescence rate 42 days after any ASMQ treatment was 2.4% for patients enrolled in Asia and 2.5% in Africa, before artemisinin resistance emerged. Corresponding rates in children aged 1 to < 5 years were 2.9% and 3.3%. After adjusting for background artemisinin resistance, the hazard of recrudescence was higher in children aged 1 to < 5 years than in adults in Asia, but not in Africa (Asia, HR 3.01, 95%CI 1.60-5.64, p < 0.001; Africa HR 5.18, 95% CI 0.61-44.28, p = 0.133). There was only one recrudescent infection in South America. A significant MQ dose-effect was observed in Asia in patients treated with 3-dose regimens (AHR 0.89, 95% CI 0.83-0.96, p = 0.003 for 1 mg/kg increase in dose). Vomiting rates within an hour of dosing were highest in children 1- 5 years of age (n = 140) at 3.4% doses (13/378) compared to 1.7% (20/1,168) in children 5-11 years (n = 476), and 1.1% (47/4,191) in patients 12 years of age or older (n = 2027) (p < 0.001, test for trend). Conclusion: AS-MQ administered over three days is a highly efficacious ACT in low to moderate transmission areas without artemisinin resistance. While further optimisation of the mefloquine dose in the coformulation in children aged 1-5 years could be considered, dose-related early vomiting is highest in this age group and may preclude this.",
  "abstract_shown": true,
  "affiliations": [],
  "article_type": null,
  "arxiv": null,
  "author_total": 46,
  "authors": [
    {
      "name": "Elizabeth A Ashley"
    },
    {
      "name": "Emmanuel Baron"
    },
    {
      "name": "Marielle K Bouyou Akotet"
    },
    {
      "name": "Rebekah Burrow"
    },
    {
      "name": "Gwenaelle Carn"
    },
    {
      "name": "Verena I Carrara"
    },
    {
      "name": "Emmanuelle Comets"
    },
    {
      "name": "Chantal Csajka"
    },
    {
      "name": "Umberto d'Alessandro"
    },
    {
      "name": "Nicholas P Day"
    },
    {
      "name": "Abdoulaye A. Djimde"
    },
    {
      "name": "Arjen Dondorp"
    },
    {
      "name": "Stephan Duparc"
    },
    {
      "name": "Mabul Faiz"
    },
    {
      "name": "Marcelo Urbano Ferreira"
    },
    {
      "name": "Lawrence Fleckenstein"
    },
    {
      "name": "Oumar Gaye"
    },
    {
      "name": "Blaise Genton"
    },
    {
      "name": "Philippe J Guerin"
    },
    {
      "name": "Eva Maria Hodel"
    },
    {
      "name": "Georgina S Humphreys"
    },
    {
      "name": "Peter G. Kremsner"
    },
    {
      "name": "Srivicha Krudsood"
    },
    {
      "name": "Simone Ladeia-Andrade"
    },
    {
      "name": "Gilbert Lefevre"
    },
    {
      "name": "Rashid Mansoor"
    },
    {
      "name": "Mayfong Mayxay"
    },
    {
      "name": "Paul N Newton"
    },
    {
      "name": "François Nosten"
    },
    {
      "name": "Aung Pyae Phyo"
    },
    {
      "name": "Ric N. Price"
    },
    {
      "name": "Sasithon Pukrittayakamee"
    },
    {
      "name": "Michael Ramharter"
    },
    {
      "name": "Ronnatrai Rueangweerayut"
    },
    {
      "name": "Issaka Sagara"
    },
    {
      "name": "Sodiomon B. Sirima"
    },
    {
      "name": "Frank M. Smithuis"
    },
    {
      "name": "Kasia Stepniewska"
    },
    {
      "name": "Walter R. J. Taylor"
    },
    {
      "name": "Innocent Valéa"
    },
    {
      "name": "Neena Valecha"
    },
    {
      "name": "Ingrid V. F. van den Broek"
    },
    {
      "name": "Rob W van Der Pluijm"
    },
    {
      "name": "Michele van Vugt"
    },
    {
      "name": "Stephen A. Ward"
    },
    {
      "name": "Nicholas J. White"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/29xt4ed558sg5.bib",
  "cited_by": 0,
  "doi": "10.1186/s12936-026-05963-4",
  "fulltext_url": null,
  "id": "29xt4ed558sg5",
  "issns": [
    "1475-2875"
  ],
  "landing_url": "https://hal.science/hal-05855046v1",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "hal",
      "0.sdv"
    ],
    [
      "openalex",
      "2739|Malaria Research and Control"
    ]
  ],
  "openalex": "W7204126087",
  "pdf_url": "https://hal.science/hal-05855046/document",
  "pmcid": null,
  "pmid": "42638106",
  "published": "2026-11-06",
  "publisher": "BioMed Central",
  "ris": "https://research.draconitic.com/paper/29xt4ed558sg5.ris",
  "sources": [
    {
      "first_seen": "2026-11-07T12:20:25Z",
      "native_id": "hal-05855046",
      "source": "hal",
      "url": "https://hal.science/hal-05855046v1"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2739|Malaria Research and Control",
      "subfield": "epidemiology-public-health"
    }
  ],
  "title": "The effect of mefloquine dose on outcome of uncomplicated falciparum malaria treated with artesunate-mefloquine: a WWARN systematic review and individual patient data meta-analysis",
  "title_text": "The effect of mefloquine dose on outcome of uncomplicated falciparum malaria treated with artesunate-mefloquine: a WWARN systematic review and individual patient data meta-analysis",
  "type": "peer-reviewed",
  "updated_at": "2026-11-08T12:20:49Z",
  "url": "https://research.draconitic.com/paper/29xt4ed558sg5",
  "venue": "Malaria Journal",
  "versions": []
}