Nutritional Advice El Mondo
Objectives:
Chemoprophylaxis with weekly doses of tafenoquine (200 mg/day for 3 days before departure [loading dose], 200 mg/week during travel and one-week post-travel [maintenance doses]) is effective in preventing malaria. Effectiveness of malaria chemoprophylaxis drugs in travellers is often compromised by poor compliance. Shorter schedules that can be completed before travel, allowing “drug-free holidays”, could increase compliance and thus reduce travel-related malaria. Therefore, this review article (meta-analysis) has been conducted.
Is a loading dose of tafenoquine alone effective in preventing malaria in short-term travellers?
Study design:
This review article included 9 RCTs with a total of 1,714 participants.
Results and conclusions:
The investigators found in long-term travellers, compared to mefloquine, tafenoquine with maintenance doses [OR = 1.05, 95% CI = 0.44 to 2.46] was equally effective in preventing malaria, while there was an increased risk of infection with the loading dose of tafenoquine alone [OR = 2.89, 95% CI = 0.78 to 10.68] and placebo [OR = 62.91, 95% CI = 8.53 to 463.88].
The investigators found in short-term travellers, loading dose of tafenoquine alone [OR = 0.98, 95% CI = 0.04 to 22.42] and tafenoquine with maintenance doses [OR = 1.00, 95% CI = 0.06 to 16.10] were as effective as mefloquine.
The investigators found the risk of adverse events (AEs) with tafenoquine with maintenance doses [OR = 1.03, 95% CI = 0.67 to 1.60] was similar to mefloquine, while loading dose of tafenoquine alone [OR = 0.58, 95% CI = 0.20 to 1.66] was associated with lower risk of AEs, although the difference was not statistically significant.
The investigators concluded for short-term travellers, loading dose of tafenoquine alone is equally effective, has possibly lower rate of adverse events (AEs) and likely better compliance than standard tafenoquine or mefloquine chemoprophylaxis schedules with maintenance doses. Studies are needed to confirm if short-term travellers remain free of infection after long-term follow-up.
Original title:
Efficacy of a 3-day pre-travel schedule of Tafenoquine for malaria chemoprophylaxis: A network meta-analysis by Islam N, Wright S, […], Furuya-Kanamori L.
Link:
https://pubmed.ncbi.nlm.nih.gov/33834208/
Additional information of El Mondo:
Find more information/studies on RCTs/cohort/significantly/review article, malaria and food fortification/malnutrition right here.