Table 1.
Efficacy of doxycycline for prophylaxis*
| Country (population) | Study type | Sample size on doxycycline | Duration of prophylaxis | Efficacy (95% CI, if reported) |
|---|---|---|---|---|
| Kenya (semi-immune)10 | Randomized, double-blind, comparators = azithromycin daily (N = 59), azithromycin weekly (N = 58), and placebo | 55 | 10 weeks | Doxycycline: 92.6% (79.9–97.5%) |
| Azithromycin daily: 82.7% (68.5–91.1%) | ||||
| Azithromycin weekly: 64.2% (47.1–77.1%) azithromycin weekly | ||||
| Kenya (semi-immune, children aged 9–14)11 | Randomized, double-blind, comparators = primaquine daily (N = 32), proguanil daily plus chloroquine weekly (N = 37), vitamin daily plus weekly mefloquine (N = 30), vitamin alone (N = 34) | 32 | 11 weeks | Doxycycline: 84% (66–92%) |
| Primaquine: 85% (68–93%) | ||||
| Mefloquine: 77% (55–88%) | ||||
| Chloroquine plus proguanil: 54% (25–72%) | ||||
| Gabon and Central African Republic (non-immune)12 | Randomized, open-label, comparator = CP (N = 270) | 171 | Travel: 4 months | Doxycycline: 97.0% |
| CP: 98.9% | ||||
| Irian Jaya (non-immune)13 | Randomized, double-blind, comparator = MQ (N = 68) and placebo | 67 | 13 weeks | Doxycycline: 99% (94–100%) overall, 98% (88–100%) for P. falciparum, 100% (90–100%) for P. vivax |
| MQ: 100% (96–100%) overall, 100% (93–100%) for P. falciparum, 100% (91–100%) for P. vivax | ||||
| Thai–Burmese border (semi-immune children aged 10–16 years)14 | Randomized, open-label, comparators = half-dose doxycycline (N = 77), placebo | 67 | 5 months | Full-dose: 5 cases/1070 person-weeks |
| Half-dose: 20 cases/1176 person- weeks | ||||
| Thai-Burmese border (semi-immune children aged 19015 years)15 | Randomized, open-label, comparator = CQ (N = 93) | 95 | 9 weeks | Doxycycline: 5 cases/597 person-weeks |
| CQ: 31 cases/488 man-weeks | ||||
| Papua New Guinea (PNG), Malaysia, Thailand (non-immune)16 | Open-label, comparators = MQ (N = 40, PNG), doxycycline + PQ (N = 69, PNG), doxycycline + CQ (N = 125, Malaysia and Thailand) | 60 | 6 weeks | Doxycycline (N = 60): 100% for P. falciparum, 96.7% for P. vivax |
| 55 | 3 weeks | Doxycycline (N = 55): 100% for P. falciparum, 76.4% for P. vivax | ||
| MQ: 100% for P. falciparum, 90% for P. vivax | ||||
| Doxycycline + PQ: 100% for both P. falciparum and P. vivax | ||||
| Doxycycline + CQ: | ||||
| Thai-Kampuchean border (non-immune)17 | Randomized, open-label, comparators = half-dose doxycycline (N = 243) or phyrimethamine + dapsone (N = 123), adherence observed but not enforced | 243 | 17 weeks | 81% (Adherence 73% for both doxycycline groups) |
| Irian Jaya, Indonesia (non-immune)18 | Randomized, double-blind, placebo-controlled, comparators: azithromycin (N = 148), placebo | 75 | 20 weeks | Doxycycline: 97.1% (91.2–99.4%) overall, 96.3% (85.4–99.6%) P. falciparum, 98.0% (88.0–99.9%) P. vivax |
| Azithromycin: 84.7% (75.5–90.7%) overall, 71.6% (50.3–83.8%) P. falciparum, 98.9% (93.1–99.9%) P. vivax |
*
CI = confidence interval; CP = chloroquine-proguanil; MQ = mefloquine; PQ = primaquine; CQ = chloroquine.