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)

Twenty-six patients with severe falciparum malaria were randomized to be treated with quinine or artemether. Twelve patients received quinine at the standard dose and fourteen patients received artemether intramuscularly at a total dose of 640 mg over 7 days. The patients were kept in the hospital for at least 7 days. Peripheral smear was performed 6-hourly until there was no parasitemia, then daily until discharged. Adverse effects were monitored through physical examination, laboratory findings and questionnaires. Laboratory examination was performed on admission, day 2, day 4 weekly until discharged. The patients in both groups were comparable in age, body weight, admission parasitemia, hemoglobin and white blood cell count. The survival rates were 93% and 58% in artemether and quinine groups, respectively (p = 0.052 at 95% confidence, using Fisher's exact test). The parasite and fever clearance times, and the time taken to gain consciousness in cerebral malaria patients were not significantly different between the two groups. Adverse effects in the quinine group consisted of dizziness and vertigo which were found in 4 patients. No adverse effects were noticed in the artemether group. This preliminary report suggests that artemether is a good alternative drug for severe falciparum malaria and seems to be better than quinine regarding survival rate and side effects. Confirmation of these findings in a larger study size is needed.
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PMID:Preliminary report: a comparative clinical trial of artemether and quinine in severe falciparum malaria. 129 87

Owing to a misunderstanding a 26-year-old man took for malaria prevention 2 tablets (1.0 g) chloroquine daily instead of the recommended dose of two tablets weekly. After 2 weeks he developed vertigo, generalized weakness and, after sun-bathing, severe bullous light reaction. After 4 weeks generalized hair depigmentation occurred. Two weeks later abnormal accommodation and double vision set in so that he lost distant and near vision. All these signs disappeared after the drug was discontinued (vertigo, weakness and abnormal accommodation within 2 weeks; hair regrew in normal colour after 8 weeks). This case shows the whole spectrum of subacute chloroquine overdosage.
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PMID:[Subacute chloroquine overdosage]. 191 22

Multidrug-resistant falciparum malaria is a major health problem along the Thai-Burmese border. From July 1985 until December 1986 a total of 5192 patients with falciparum malaria (1734 males, 3458 females) from this area were given supervised treatment with the combination mefloquine-sulfadoxine-pyrimethamine (MSP). The radical cure rate, assessed 21 days after drug administration, was 98.4% for the first 1975 patients, and 98.8% when assessed at 28 days for the remaining 3217 patients. In 3.8% of cases, parasites were still detected in peripheral blood smears on day 7 after treatment but this had fallen to 0.27% by day 9. Adverse reactions among the first 1975 patients were: vertigo (7.5% of patients), vomiting (5.8%), epigastric pain (0.6%), and transient confusional state (one case). MSP is an effective and well-tolerated drug for the treatment of drug-resistant falciparum malaria; however, delayed parasite clearance may give a false impression of RII resistance.
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PMID:Malaria on the Thai-Burmese border: treatment of 5192 patients with mefloquine-sulfadoxine-pyrimethamine. 332 87

An open, non-comparative clinical trial was carried out in Nigeria and Burkina Faso to investigate the safety and efficacy of the novel antimalarial arteflene in patients with mild malaria. Patients were males aged 12 to 16 years, with a Plasmodium falciparum count of 10(4) to 10(5) parasites/microliters and a body temperature of 37.5 to 38.5 degrees C. Twenty-three patients received a single dose of Ro 42-1611 (arteflene), corresponding to 25 +/- 2.5 mg/kg bodyweight. Nineteen patients were evaluable for standard efficacy. Efficacy was assessed at 6, 9, 12, 24, 36, 48 and 72 hours, and at seven days, by: reduction in parasitaemia and time to parasite clearance; resolution of fever; and clinical cure (defined as the absence of signs and symptoms of malaria). Adverse events were reported at each assessment point, and laboratory tests were carried out at baseline and at 2 and 7 days. The parasite count was reduced by 50% or more in 89.5% of patients after 48 hours, and 52.6% were completely free of parasites at the same time. Normal temperature was achieved in 89.5% of patients and clinical cure in 75%, after 48 hours. One patient reported mild vertigo and mild pruritus. The lower than expected effect was thought to be due to inadequate storage of the arteflene suspension. There were no withdrawals due to adverse events and no deaths. A single dose of 25 mg/kg arteflene was found to be an effective and well-tolerated treatment for mild P. falciparum malaria.
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PMID:Ro 42-1611 in the treatment of patients with mild malaria: a clinical trial in Nigeria and Burkina Faso. 789 5

A pharmacokinetic study with (malaria) prophylactic doses of mefloquine hydrochloride was conducted in 12 healthy adult subjects (Caucasians), 6 females and 6 males, mean age 29.2 +/- 6.4 years, mean weight 70.6 +/- 13.4 kg. Doses of 250 mg mefloquine were administered on days 0, 1, 7, 14, 21 and 28. Six subjects received a further 5 weekly doses of 250 mg mefloquine, the others 5 further weekly doses of 125 mg. After the third dose the protective threshold mefloquine concentration in blood plasma was achieved in all subjects. In female subjects, mean Cmin ss, Cmax ss and AUCd 0-35 were significantly higher than in males. After the fifth dose, mean Cmax in females reached 1692 ng/ml (4.48 mumol/l), equivalent to a high therapeutic concentration. This is apparently due to a generally lower body weight and a narrower volume of distribution in women. Adverse reactions were significantly more frequent in women than in men. Headache, anorexia, insomnia and vertigo were the most common side effects. The lesser tolerability of mefloquine in females may be due to the higher drug concentrations in this group. This may indicate the need for appropriate adjustment of the prophylactic dose regimen of mefloquine in females.
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PMID:Mefloquine concentration profiles during prophylactic dose regimens. 1089 Jan 33

The frequency and spectrum of adverse events associated with the antimalarial therapeutic regimen of mefloquine (MQ) (750 and 500 mg at an interval of 6 h) was assessed in 22 healthy volunteers who were monitored for 21 days following drug administration. An unexpected high frequency of side effects of any grade were reported by all 22 subjects. The most commonly reported symptoms were vertigo (96%), followed by nausea (82%) and headache (73%). Participants suffering from severe (grade 3) vertigo (73%) required bed rest and specific medication for 1 to 4 days. More females than males reported severe adverse reactions. The majority (77.3%) of the participants (f: 8/12, m: 9/10) showed symptom resolution within 3 weeks (510 h) after drug administration. Biochemical and haematological findings stayed within the normal range of values, but showed nevertheless a significant rise of Na, Cl, Ca, bilirubin, GGT and LDH. The unexpectedly high frequency and severity of adverse reactions after normal therapeutic dosage of MQ in healthy subjects may influence future recommendations regarding the use of MQ for stand-by treatment of suspected malaria in travellers.
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PMID:Unexpected frequency, duration and spectrum of adverse events after therapeutic dose of mefloquine in healthy adults. 1180 Dec 24

At a public hospital in Georgetown, Guyana, 44 patients seeking treatment for symptomatic, slide-confirmed malaria were given standard chloroquine (CQ) therapy and followed for 28 days. The patients apparently had pure infections with Plasmodium falciparum (14), P. vivax (13) or P. malariae (one), or mixed infections either of P. falciparum and P. vivax (17) or of P. falciparum, P. malariae and P. vivax (two). Each received supervised treatment with 10 mg CQ base/kg on each of days 0 and 1, and 5 mg/kg on day 2. On the day of enrollment (day 0), the patients complained of fever (100%), headache (100%), malaise (94%), myalgia (79%), nausea (67%), vertigo (49%) and vomiting (33%). Many (39%) were ill enough to confine themselves to bed. On day 4, fewer of the subjects complained of fever (15%), headache (15%), malaise (6%), myalgia (21%), nausea (6%), vertigo (24%) or vomiting (0%) despite the relatively high (>48%) risk of therapeutic failure. The cumulative incidence of parasitological failure against P. falciparum was 15% at day 4, 33% at day 7 and 48% at day 14. All of the P. vivax and P. malariae infections cleared before day 4 and none recurred by day 7. Two infections with P. vivax recurred later (on day 14 or 28) but in the presence of less than adequate, whole-blood concentrations of CQ plus desethyl-chloroquine (i.e. <100 ng/ml). Taken together, the results indicate a high risk of therapeutic failure of CQ against P. falciparum but also indicate that resistance to CQ in P. vivax occurs infrequently in Guyana.
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PMID:Chloroquine for the treatment of uncomplicated malaria in Guyana. 1217 15

The resistance of Plasmodium falciparum to the chloroquine-proguanil association (C/P) as antimalarial chemoprophylaxis is becoming increasingly common in Africa. Daily oral doxycycline hyclate 100 mg is effective as malaria prophylaxis. But the hyclate salt's adverse effects combined with the capsule's galenic form are incompatible with good chemoprophylaxis compliance. We conducted a randomized group study of 522 French soldiers deployed in Gabon and Chad for 4 months to determine the tolerability of short-term malaria chemoprophylaxis with a 100-mg daily tablet of a monohydrate doxycycline salt compared with a daily C/P capsule. At days 7 and 120, compliance was better in the doxycycline group [respectively 98.5%vs. 73.9% (P < 0.001) and 90.5%vs. 74% (P < 0.001)]. No major event (evacuation, hospitalization) was related to the medications. Epigastralgia, diarrhoea, urticaria, mouth ulcers, sun sensitization and desquamation were significantly more frequent in the C/P group (P < 0.05). There was no statistical difference for malaria incidence, vertigo, nausea and hair loss. These results suggest that doxycycline monohydrate may be safely used in short-term malaria chemoprophylaxis. With the same efficacy as a hyclate doxycycline, doxycycline monohydrate could be a good chemoprophylaxis for short-term travellers at particular risk of C/P resistant P. falciparum malaria.
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PMID:Tolerability of doxycycline monohydrate salt vs. chloroquine-proguanil in malaria chemoprophylaxis. 1239 May 96

Travel is associated with a number of neurological disorders that can be divided into two categories: (1) Neurological infections including encephalitides, neurotuberculosis, neurobrucellosis, cysticercosis and trichinosis. Some of these disorders can be prevented by vaccinations, such as Japanese B encephalitis and rabies, some by the use of insect repellents and some by avoiding raw milk products and undercooked meat. (2) Non-infective neurological disorders, such as acute mountain sickness and high altitude cerebral oedema, problems occurring during air travel such as syncope, seizures, strokes, nerve compression, barotrauma and vertigo, motion sickness and foodborne neurotoxic disorders such as ciguatera, shellfish poisoning and intoxication by cassava. This group of diseases and disorders could be prevented if the traveller knows about them, applies simple physiological rules, takes some specific medications and knows how to avoid intoxications in certain geographical areas. Meningococcal meningitis, malaria and jet lag syndrome are extensively discussed in other articles of this issue. The discussion in this paper will be limited to the other disorders.
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PMID:Neurological disorders and travel. 1261 85

Mefloquine has been licensed and registered in Japan for chemoprophylaxis against malaria since 2001. Guidelines for the prevention of malaria for Japanese overseas travelers were published by a group of malaria specialists under the auspices of the Japanese Society of Tropical Medicine and the Ministry of Health, Labor and Welfare, but not until March 2005. We implemented these guidelines in our clinic at the International Medical Center of Japan in Tokyo and, to better understand whether these guidelines are optimally useful, we conducted a study of Japanese travelers who visited our clinic seeking pertinent information and prophylaxis against malaria. The study group comprised 52 individuals who visited our clinic during the period October 2004 through June 2005 prior to travel abroad. On the basis of the above-mentioned guidelines, mefloquine was given to 27 of these individuals, 22 of whom were judged to need regular chemoprophylaxis. Mefloquine was not recommended to the other 25 individuals because their stays abroad would have been too long to avoid possible side effects or too short for symptoms to appear. In fact, some were traveling to malaria-free areas. Of the 27 individuals given mefloquine, 7 (26%) reported side effects, such as headache, vertigo, and nausea, 17 (63%) reported no side-effects, and the other 3 (11%) were unable to be followed. The diversity of destinations and accompanying malaria risks makes it very difficult for us to administer chemoprophylaxis to overseas travelers appropriately. The guidelines proved to be somewhat useful, but further experience in malaria chemoprophylaxis is needed for physicians to provide reliable pre-travel consultation.
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PMID:Chemoprophylaxis according to the guidelines on malaria prevention for Japanese overseas travelers. 1754 42


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