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

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.

Received December 8, 2004. Accepted for publication February 10, 2005.

Acknowledgments: We wish to acknowledge all pregnant women who participated in this study and the midwives at the General Hospital and the Albert Schweitzer Hospital in Lambaréné. We also thank Anselme Ndzengue, Brigitte Migombet, and Ariane Ntseyi for excellent technical assistance and Drs. Elie Mavoungou and Bertrand Lell for critical comments on the manuscript.

^* Address correspondence to Ayôla A. Adegnika, Medical Research Unit, Albert Schweitzer Hospital, Lambaréné, Gabon. E-mail: aadegnika{at}yahoo.com

Authors’ addresses: Ayôla A. Adegnika, Lutz Ph. Breitling, Selidji T. Agnandji, Daniela Schütte, Sunny Oyakhirome, Norbert G. Schwarz, Martin P. Grobusch, Michel A. Missinou, Michael Ramharter, Saadou Issifou, Sanders K. Chai, and Peter G. Kremsner, Medical Research Unit, Albert Schweitzer Hospital, Lambaréné, BP 118, Gabon, Telephone: 00241 581099, Fax: 00241 581196. Ayôla A. Adegnika, Martin P.Grobusch, Michel A. Missinou, Michael Ramharter, Saadou Issifou, and Peter G. Kremsner, Institute of Tropical Medicine, University of Tübingen, Wilhelmstrasse 27, 72074 Tübingen, Germany. Michael Ramharter, Department of Internal Medicine I, Division of Infectious Diseases, Medical University of Vienna, Vienna, Austria.

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