Comparison of Capillary Whole Blood, Venous Whole Blood, and Plasma Concentrations of Mefloquine, Halofantrine, and Desbutyl-Halofantrine Measured by High-Performance Liquid Chromatography

Feiko O. Ter Kuile Faculty of Tropical Medicine, Mahidol University, Shoklo Malaria Research Unit, Unit of Infectious Diseases and Tropical Medicine, Academic Medical Center, University of Amsterdam, Armed Forces Research Institute of Medical Sciences (AFRIMS), Nuffield Department of Clinical Medicine, John Radcliffe Hospital, Bangkok, Thailand

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Paktiya Teja-Isavatharm Faculty of Tropical Medicine, Mahidol University, Shoklo Malaria Research Unit, Unit of Infectious Diseases and Tropical Medicine, Academic Medical Center, University of Amsterdam, Armed Forces Research Institute of Medical Sciences (AFRIMS), Nuffield Department of Clinical Medicine, John Radcliffe Hospital, Bangkok, Thailand

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Michael D. Edstein Faculty of Tropical Medicine, Mahidol University, Shoklo Malaria Research Unit, Unit of Infectious Diseases and Tropical Medicine, Academic Medical Center, University of Amsterdam, Armed Forces Research Institute of Medical Sciences (AFRIMS), Nuffield Department of Clinical Medicine, John Radcliffe Hospital, Bangkok, Thailand

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Duangsuda Keeratithakul Faculty of Tropical Medicine, Mahidol University, Shoklo Malaria Research Unit, Unit of Infectious Diseases and Tropical Medicine, Academic Medical Center, University of Amsterdam, Armed Forces Research Institute of Medical Sciences (AFRIMS), Nuffield Department of Clinical Medicine, John Radcliffe Hospital, Bangkok, Thailand

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Grainne Dolan Faculty of Tropical Medicine, Mahidol University, Shoklo Malaria Research Unit, Unit of Infectious Diseases and Tropical Medicine, Academic Medical Center, University of Amsterdam, Armed Forces Research Institute of Medical Sciences (AFRIMS), Nuffield Department of Clinical Medicine, John Radcliffe Hospital, Bangkok, Thailand

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Francois Nosten Faculty of Tropical Medicine, Mahidol University, Shoklo Malaria Research Unit, Unit of Infectious Diseases and Tropical Medicine, Academic Medical Center, University of Amsterdam, Armed Forces Research Institute of Medical Sciences (AFRIMS), Nuffield Department of Clinical Medicine, John Radcliffe Hospital, Bangkok, Thailand

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Lucy Phaipun Faculty of Tropical Medicine, Mahidol University, Shoklo Malaria Research Unit, Unit of Infectious Diseases and Tropical Medicine, Academic Medical Center, University of Amsterdam, Armed Forces Research Institute of Medical Sciences (AFRIMS), Nuffield Department of Clinical Medicine, John Radcliffe Hospital, Bangkok, Thailand

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H. Kyle Webster Faculty of Tropical Medicine, Mahidol University, Shoklo Malaria Research Unit, Unit of Infectious Diseases and Tropical Medicine, Academic Medical Center, University of Amsterdam, Armed Forces Research Institute of Medical Sciences (AFRIMS), Nuffield Department of Clinical Medicine, John Radcliffe Hospital, Bangkok, Thailand

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Nicholas J. White Faculty of Tropical Medicine, Mahidol University, Shoklo Malaria Research Unit, Unit of Infectious Diseases and Tropical Medicine, Academic Medical Center, University of Amsterdam, Armed Forces Research Institute of Medical Sciences (AFRIMS), Nuffield Department of Clinical Medicine, John Radcliffe Hospital, Bangkok, Thailand

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DOI:
https://doi.org/10.4269/ajtmh.1994.51.778
Volume/Issue:
Volume 51: Issue 6
Page(s):
778–784
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Whole blood mefloquine, halofantrine, and desbutyl-halofantrine concentrations were measured by high-performance liquid chromatography in capillary blood, venous blood, and venous plasma samples from patients along the Thai/Burmese border with falciparum malaria who were treated with either mefloquine (25 mg/kg) or halofantrine (24 mg/kg or 72 mg/kg). The limits of detection for mefloquine, halofantrine, and desbutyl-halofantrine were 50, 15, and 10 ng/ml, respectively, with 200 µl whole blood samples. There was a good linear correlation (r > 0.9) between capillary and venous blood and between whole blood and plasma for all three compounds. Mefloquine concentrations in venous and capillary blood were very similar (mean ratio 1.02, 95% confidence intervals [CI] 0.95–1.09, n = 60), but were 1.15 times higher (95% CI 1.03–1.29) in whole blood than in plasma (n = 22). The halofantrine and desbutyl-halofantrine concentrations were 1.27 (1.12–1.45, n = 23) and 1.34 (1.16–1.55, n = 24) times higher in venous compared to capillary blood, while halofantrine but not desbutyl-halofantrine concentrations were lower in whole blood than in plasma (mean ratios: halofantrine: 0.83 [0.72, 0.94], n = 39 and desbutyl-halofantrine: 1.05 [0.96–1.15], n = 41). Measurement of mefloquine, halofantrine, or desbutyl-halofantrine in capillary blood is an accurate and practical alternative to venous blood sampling, and is particularly useful for sampling with children, and under field conditions when technical facilities are limited.

Author Notes

Copyright:
Copyright © 1994 by The American Society of Tropical Medicine and Hygiene 1994
Published Online:
Dec 1994
Cover The American Journal of Tropical Medicine and Hygiene
The American Journal of Tropical Medicine and Hygiene
Print ISSN:
0002-9637
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