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April 1, 1998

Malaria Prevention for Travelers

Author Affiliations

Margaret A.WinkerMD, Senior EditorIndividualAuthorPhil B.FontanarosaMD, Senior EditorIndividualAuthor

JAMA. 1998;279(13):990-991. doi:10-1001/pubs.JAMA-ISSN-0098-7484-279-13-jbk0401

To the Editor.—Drs Lobel and Kozarsky1 provide us with their clinical opinion that mefloquine is the drug of choice for most travelers going to malarious areas, but they do not systematically summarize the evidence that led them to this conclusion. We sought systematically available evidence in randomized trials (searching from 1966 to September 1997) and identified 37 possible studies, 10 of which met our prespecified inclusion criteria.2,3 Our review identified as a primary outcome the numbers of participants withdrawing during the study period. This end point is a more reliable indicator of toxicity than reported symptoms as withdrawal indicates that a threshold of tolerability has been reached.4

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