Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0024530 (malaria)
 44,886 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

One hundred and thirteen children with symptomatic uncomplicated falciparum malaria were treated with either chloroquine 25 mg/kg body weight over 3 d (51 subjects) or mefloquine 25 mg/kg body weight single dose (62 subjects). The cure rate in the chloroquine group was 65% and in the mefloquine group 100%. 14 patients with chloroquine-resistant falciparum malaria (7 RI, 6 RII and one RIII) were successfully treated with mefloquine. The clearance times of parasitaemia and fever were 60 +/- 21.5 h and 24.7 +/- 10.1 h respectively in the chloroquine-sensitive group and 52.3 +/- 18.2 h and 24.5 +/- 23.7 h respectively in the mefloquine group. In the chloroquine-resistant group treated successfully with mefloquine, these clearance times were 44.0 +/- 8.9 and 24.0 h respectively. The only remarkable adverse reaction in the chloroquine group was pruritus which occurred in 7 subjects. Abdominal pain and diarrhoea (8 subjects) and dizziness (3 subjects) were the only important adverse reactions in the mefloquine group. It is concluded that, despite previous reports of primary reduced susceptibility to mefloquine in vitro of some West African isolates of Plasmodium falciparum, this drug may be useful in the treatment of both chloroquine-sensitive and chloroquine-resistant falciparum malaria in West Africa.
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PMID:Clinical efficacy of mefloquine in children suffering from chloroquine-resistant Plasmodium falciparum malaria in Nigeria. 209 99

Fifty subjects with acute symptomatic uncomplicated falciparum malaria were treated orally with halofantrine hydrochloride 500 mg 6 hourly for 3 doses if their body weight was 40 kg and above, or 8 mg/kg body weight 6 hourly for 3 doses if their weight was below 40 kg. Parasitaemia cleared in all subjects within 72 h. There was recurrence of parasitaemia in 9 subjects after day 14, and retreatment with halofantrine resulted in prompt clearance of parasitaemia in all but one of these patients. The mean clearance times of parasitaemia, fever and other symptoms were 33.6 +/- 13.0 h, 20.7 +/- 15.3 h, and 35.0 +/- 10.7 h respectively. Minor gastrointestinal side effects occurred in 2 subjects and pruritus in 7 subjects. The pruritus was mild in all but one subject. Haematological and biochemical indices were not adversely affected by treatment except in one subject in whom liver enzymes were elevated before treatment and more than doubled following treatment.
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PMID:Evaluation of the clinical efficacy and safety of halofantrine in falciparum malaria in Ibadan, Nigeria. 227 61

The mechanisms whereby the intrinsic pruritogenic effect of chloroquine (a property also encountered among some other 4-amino-quinolines including amodiaquine) becomes aggravated during paroxysmal malarial suppressive chemotherapy with the drug form the basis of this paper. Physiological itching has been linked to the concept of 'spontaneous itch', as compared to pathological itching which has been associated with another concept of 'itching hyperexcitability', and the pathophysiology of pruritus, including the involvement of peripheral and central (neuropeptide) mediators of itch, were considered. The modulating function of spinal and supraspinal 'gateway control' mechanisms, which have been used to explain the overriding effect of pain-over-itch sensation, were also considered and related to itching hyperexcitability. From current data and the records of previously-published reactions to chloroquine, during fever or malarial chemotherapy in man and some mammals, the possible involvement of racial and skin pigment factors, histamine factor, other peripheral mediators of itch, tissue pharmacokinetic factors, central mediators of itch, pyrogenic haemodynamics, and 'gateway' modulation in producing enhanced pruritic reaction during chloroquine antimalarial chemotherapy, were examined in relation to the aggravating role of ischaemia on itch excitability. A trilateral approach to the clinical management of chloroquine-induced pruritus among patients with malaria has been used. In line with the principles of clinical treatment of severe generalized pruritus of uncertain aetiology, this approach has been adapted to reflect the epidemiological, clinical and pathophysiological variables that appear to influence chloroquine-induced pruritus.
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PMID:Mechanisms of enhanced pruritogenicity of chloroquine among patients with malaria: a review. 254 86

The effects of single doses of placebo, clemastine, ketotifen and prednisolone on chloroquine-induced pruritus were investigated in healthy black African volunteers using a visual analogue scale. There was no significant differences between the mean percentage degrees of pruritus recorded with placebo, clemastine and ketotifen. By contrast, the mean percentage degree of pruritus recorded with prednisolone was significantly lower than those with the other three treatments. If these results are confirmed in patients with malaria, it might be more rational to administer a single prophylactic dose of prednisolone in those who experience very disturbing pruritus with chloroquine.
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PMID:Effects of clemastine, ketotifen and prednisolone on chloroquine-induced pruritus. 281 Apr 54

The association of pruritus and ingestion of chloroquine phosphate in Saradidi, Kenya, was determined by randomly giving 437 children (less than 18 years) and 182 adults either 10 mg base kg-1 of regular chloroquine, 10 mg base kg-1 of enteric-coated chloroquine, 10 mg base kg-1 of amodiaquine, or one 300 mg tablet of enteric-coated ferrous sulphate. Before treatment, a blood smear was taken. Paired urine samples were tested for 4-aminoquinolines to exclude prior drug ingestion, to document drug absorption, and to exclude chloroquine or amodiaquine intake in persons who received iron. The following day, the incidence of itching was ascertained. More adults (20.3%) reported itching than did children (12.8%) (P less than 0.05); no significant difference between males and females was noted. A history of itching 24 hours after treatment was not significantly more common in persons with malaria parasitaemia. Pruritus was more frequent in those receiving regular chloroquine (21.5% of 186) and enteric-coated chloroquine (17.8% of 118) than after amodiaquine (11.6% of 173) or iron (8.5% of 142) (P less than 0.005). Amodiaquine which is a 4-aminoquinoline like chloroquine did not appear to cause significant pruritus in this population. These results demonstrate that chloroquine-associated pruritus is experienced frequently in Saradidi. This side effect of malaria treatment could influence usage of chloroquine phosphate provided by village health workers.
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PMID:Epidemiology of chloroquine-associated pruritus in Saradidi, Kenya. 296 16

Many classes of drugs exert anti-inflammatory activity through mechanisms which affect all or part of the inflammatory process. Some of these agents are beneficial in the practice of dermatology, while others, such as penicillamine, mast cell blockers and serotonin antagonists, find little or no application. Corticosteroids, for example, are nonspecific in their anti-inflammatory effects and remain a mainstay of therapy, despite their side effect profile. Other drugs, such as the non-steroidal anti-inflammatory agents or gold, can be used in the treatment of diseases associated with rheumatic or autoimmune states. Moreover, antihistamines play an important role in the control of itching, but are mainly indicated in controlling non-dermatological allergic sequelae. Interestingly, chloroquine and dapsone, which were originally developed for use in malaria prophylaxis and leprosy, respectively, have value in treating a wide range of dermatological conditions via mechanisms which include the inhibition of P-450 isoenzymes. In diseases characterised by disturbed cornification (e.g. psoriasis pustulosa), retinoids are of particular value. These drugs are thought to act by inhibition of collagenases, proteases and granulocyte migration. Undoubtedly, further investigation of drug classes such as oxygen radical controllers and immunomodulators will clarify their mechanisms and establish their therapeutic usefulness among the anti-inflammatory agents now available for dermatological use.
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PMID:The present status of anti-inflammatory agents in dermatology. 307 31

A total of 100 male Zambian patients with symptomatic falciparum malaria were treated with either two tablets of mefloquine plus sulfadoxine-pyrimethamine (Fansimef) or three tablets of sulfadoxine-pyrimethamine (Fansidar) as a single dose. The patients were kept under observation from day 0 (day of treatment) to day 28 and all were cured. An S-type of response was seen in all patients; one patient in the Fansimef group inexplicably remained positive for Plasmodium falciparum trophozoites until day 6. There were no cases of recrudescence.The rate of clearance of parasitaemia was similar in both groups. The rate of clearance of fever was marginally faster in the Fansimef group. Side-effects such as pruritus, diarrhoea and abdominal pain occurred after both drugs but were mild and transient; tolerance was slightly better with Fansimef. Severe orthostatic hypotension occurred in 20% of the Fansidar patients and in only 2% of the Fansimef patients; this was reversed by bed rest. Haematological and biochemical parameters were generally not modified in an undesirable manner by the administration of these drugs.
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PMID:A double-blind trial of a fixed combination of mefloquine plus sulfadoxine-pyrimethamine compared with sulfadoxine-pyrimethamine alone in symptomatic falciparum malaria. 331 40

Chloroquine prophylaxis for malaria was available free of charge to pregnant women in Saradidi, Kenya. The drug was supplied by village health helpers (VHH's). However, only 29.1% of 357 pregnant women seen in antenatal clinics from 1983 to 1984 were on chemoprophylaxis. One hundred and seven pregnant women not using antimalarial chemoprophylaxis from 22 villages were interviewed in June 1984 to determine the reasons. Age (mean 26.9 years), parity (mean 4.5 children), occupation (96.3% subsistence farmers and housewives) and education (median five to seven years) of the 107 respondents were similar to other women in the area. Previous pregnancies had occurred in 92 women; for 15 this was the first pregnancy. The last pregnancy had resulted in a live birth for 81 (88.0%), a stillbirth for nine (9.8%) and a miscarriage for two (2.2%); 21 (22.8%) of the 92 had experienced a miscarriage or stillbirth at some time (15 once, five twice and one woman four times). Malaria was the most frequent mentioned (28.6% of 21 women) cause of the last stillbirth or abortion. The major reason for not taking chemoprophylaxis was lack of awareness that the service was available (53.3% of 107 women). Other reasons were fear of chloroquine-induced itching (10.3%), the VHH had no drug (8.4%), the VHH had not advised her to take drug (8.4%), the woman was 'not sick' (7.5%), the woman was 'lazy' (6.5%), she had not been advised by clinic so was afraid to mix medicines (3.7%) and chloroquine was 'bad for pregnancy' (1.9%).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Malaria chemoprophylaxis to pregnant women provided by community health workers in Saradidi, Kenya. I. Reasons for non-acceptance. 368 40

A total of 99 male Zambian patients with symptomatic falciparum malaria were treated in a double-blind randomized manner with either mefloquine (1000 mg given in one day) or chloroquine (1500 mg given over 3 days). An S-type response was seen in all the chloroquine patients and 98% of the mefloquine group; one patient in the latter group (2%) showed an RI-type response, but the parasites obtained during the recrudescence were sensitive to both chloroquine and mefloquine in the in vitro microtest, and the patient responded satisfactorily to oral chloroquine. The rate of clearance of parasitaemia was marginally faster in the chloroquine-treated group. The rate of clearance of fever was similar in the two groups. Both drugs were well tolerated and side-effects such as nausea, vomiting, dizziness, loose stools, and pruritus were mild and transient. Pruritus was more common after chloroquine administration and dizziness more common in the mefloquine group. There were no drug-induced alterations in the haematological and biochemical profiles.
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PMID:A double-blind comparative clinical trial of mefloquine and chloroquine in symptomatic falciparum malaria. 635 7

A malaria prophylaxis programme for 100 000 children in one rural district of Tanzania was carried out under the very favourable conditions of 1) a government genuinely committed to rural public health, 2) a well organized system of village government for distribution of the drug to children, and 3) free chloroquine supplied without interruption by WHO to the project area. The project failed to suppress malaria for a combination of the following reasons. Small delays in distribution because of poor communication, vehicle breakdowns, bad roads, key people being away or too busy resulted in the drug not being available for ingestion at regular intervals. A few children from families with marginal social status were excluded by local leaders. Some people were not convinced that regular chloroquine taking might prevent children's malaria and therefore saved it to treat fever in all family members. Various survey techniques were used to discover why children might refuse to swallow tablets, and as many as 28% of children complained of vomiting, as many as 56% complained of itching, and other unfavourable qualities of chloroquine were indicated.
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PMID:Failure to participate in a malaria chemosuppression programme: North Mara, Tanzania. 663 36


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