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Malaria Treatment with Atovaquone-Proguanil in Malaria-Immune Adults: Implications for Malaria Intervention Trials and for Pre-Exposure Prophylaxis of Malaria

Walter Reed Project, United States Army Medical Research Unit, Kisumu, Kenya,¹ Centre for Clinical Research, Kenya Medical Research Institute, Kisumu, Kenya,² GlaxoSmithKline Biologicals, Rixensart, Belgium,³ Walter Reed Army Institute of Research, Silver Spring, Maryland⁴

Received 23 October 2007/ Returned for modification 28 December 2007/ Accepted 10 January 2008

Eighty adults in areas of Kenya where malaria is holoendemic received presumptive treatment with atovaquone-proguanil and were followed closely. The time to the first Plasmodium falciparum parasitemia was 32 days. This prolonged prophylaxis period has implications for study design when used in malaria intervention trials and cautiously suggests clinical investigation of potential preexposure prophylaxis of malaria.

Published ahead of print on 11 February 2008.