State, north Brazil

Multidrug-resistant Plasmodium falciparum is wide-spread in the Arnazonian region of Brazil. There are reports of high rales of antifolate (pyrimethamine-sulfadoxine) resistance and resistance~o quinoline-con-taining compounds (chloroquine, quinine and amodia-quine) in different parts ofBrazil (DI SANTI et al., 1988; COUTO et al., 1993, 1995; PÓVOA et al., 1998; ZAUS et al., 1998). The drug failure led to the adoption of combination chemotherapy for the treatment of uncom-plicated malaria. Based on its reported efficacy against chloroquine-resistant parasites or infections, mefloquine was introduced by the mid-1970s as the drug of choice for the treatment of uncomplicated and complicated falciparum infection. However, reports of mefloquine resistance in South-East Asia (LASSERRE, 1989; PRICE e