Evidence
This page contains a snapshot of featured content which highlights evidence addressing key clinical questions including areas of uncertainty. Please see the main topic reference list for details of all sources underpinning this topic.
BMJ Best Practice evidence tables
Evidence tables provide easily navigated layers of evidence in the context of specific clinical questions, using GRADE and a BMJ Best Practice Effectiveness rating. Follow the links at the bottom of the table, which go to the related evidence score in the main topic text, providing additional context for the clinical question. Find out more about our evidence tables.
This table is a summary of the analysis reported in a Cochrane Clinical Answer that focuses on the above important clinical question.
Confidence in the evidence is high or moderate to high where GRADE has been performed and there is a trade-off between benefits and harms of the intervention.
Population: HIV-negative pregnant women ᵃ
Intervention: Mefloquine
Comparison: Sulfadoxine/pyrimethamine
| Outcome | Effectiveness (BMJ rating)? | Confidence in evidence (GRADE)? |
|---|---|---|
Clinical malaria episodes during pregnancy | No statistically significant difference ᵇ | High |
Placental malaria | No statistically significant difference | Low |
Maternal anaemia at delivery | Favours intervention | Moderate |
Low birthweight | No statistically significant difference | High |
Stillbirths and abortions | No statistically significant difference | Moderate |
Adverse events (vomiting; fatigue/weakness) | Occurs more commonly with mefloquine compared with sulfadoxine/pyrimethamine (favours comparison) | High |
Adverse events (dizziness) | Occurs more commonly with mefloquine compared with sulfadoxine/pyrimethamine (favours comparison) | Moderate |
Note The Cochrane review which underpins this Cochrane Clinical Answer (CCA) noted that future research should focus on finding a dose of mefloquine that will provide the same beneficial effects alongside reduced drug-related adverse events. ᵃ Women attended antenatal care clinics in Benin, Tanzania, Mozambique, and Gabon. ᵇ Two RCTs (5455 people) found that fewer people receiving mefloquine had clinical malaria episodes during pregnancy but the results did not reach statistical significance.
This evidence table is related to the following section/s:
Cochrane Clinical Answers
Cochrane Clinical Answers (CCAs) provide a readable, digestible, clinically focused entry point to rigorous research from Cochrane systematic reviews. They are designed to be actionable and to inform decision making at the point of care and have been added to relevant sections of the main Best Practice text.
- How do drugs for the prevention of malaria in pregnant women affect fetal and infant outcomes?
- In HIV‐positive pregnant women, how does mefloquine plus cotrimoxazole (trimethoprim/sulfamethoxazole) compare with cotrimoxazole alone for preventing malaria?
- In HIV‐negative pregnant women, how does mefloquine compare with sulfadoxine‐pyrimethamine for preventing malaria?
- Can insecticide‐treated nets (ITNs) help prevent transmission of malaria and improve malaria‐related outcomes?
- What are the effects of topical mosquito repellents for preventing malaria in people living in endemic areas?
- Do topical repellents help prevent malaria caused by Plasmodium falciparum?
- How does rapid diagnostic testing for malaria compare with clinical diagnosis for treating people with fever in malaria endemic settings?
- How do malaria rapid diagnostic tests compare with clinical diagnosis for diagnosing and treating malaria in adults and children in the community?
- What are the effects of artesunate versus quinine in people with severe malaria?
- How does dihydroartemisinin-piperaquine compare with artesunate-containing regimens in people with uncomplicated falciparum malaria?
- Does combining artesunate with mefloquine have any benefit over mefloquine alone for treating uncomplicated malaria?
- How does dihydroartemisinin-piperaquine compare with artemether-lumefantrine in people with uncomplicated falciparum malaria?
- How does pyronaridine plus artesunate compare with alternative antimalarial regimens for people with uncomplicated Plasmodium falciparum malaria?
- What are the benefits and harms of primaquine for reducing transmission of Plasmodium falciparum?
- How does artemether compare with quinine in children with severe malaria?
- How do different artemisinin-based therapies compare for the treatment of uncomplicated Plasmodium vivax malaria?
- How do artemisinin-based therapies (ACT) compare with non-artemisinin-based (non-ACT) regimens for the treatment of uncomplicated Plasmodium vivax malaria?
- How does artemether compare with artesunate or quinine in adolescents and adults with severe malaria?
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