Methylene blue for malaria in Africa: results from a dose-finding study in combination with chloroquine

• Published in: Malaria Journal
• Main Authors: Mikus Gerd, Walter-Sack Ingeborg, Jahn Albrecht, Schiek Wolfgang, Rengelshausen Jens, Mansmann Ulrich, Tapsoba Théophile, Witte Steffen, Coulibaly Boubacar, Mandi Germain, Meissner Peter E, Burhenne Jürgen, Riedel Klaus-Dieter, Schirmer R Heiner, Kouyaté Bocar, Müller Olaf
• Format: Article in Journal/Newspaper
• Language: English
• Published: BMC 2006
• Subjects: Arctic medicine. Tropical medicine; RC955-962; Infectious and parasitic diseases; RC109-216; Arctic
• Online Access: https://doi.org/10.1186/1475-2875-5-84; https://doaj.org/article/f80cd69892fc46799076b35caabf8c7a

Abstract The development of safe, effective and affordable drug combinations against malaria in Africa is a public health priority. Methylene blue (MB) has a similar mode of action as chloroquine (CQ) and has moreover been shown to selectively inhibit the Plasmodium falciparum glutathione reductase. In 2004, an uncontrolled dose-finding study on the combination MB-CQ was performed in 435 young children with uncomplicated falciparum malaria in Burkina Faso (CQ monotherapy had a > 50% clinical failure rate in this area in 2003). Three serious adverse events (SAE) occurred of which one was probably attributable to the study medication. In the per protocol safety analysis, there were no dose specific effects. The overall clinical and parasitological failure rates by day 14 were 10% [95% CI (7.5%, 14.0%)] and 24% [95% CI (19.4%, 28.3%)], respectively. MB appears to have efficacy against malaria, but the combination of CQ-MB is clearly not effective in the treatment of malaria in Africa.