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

There is need for effective chemoprophylaxis against chloroquine-resistant falciparum malaria, and for a safe and effective drug to be readily available for the treatment of that condition. Experience with the cases cited in this study indicates that Fansidar should be made available for treatment and it is suggested that Maloprim be made available as a prophylactic agent.
 ...
PMID:Chloroquine-resistant falciparum malaria from Papua New Guinea and its implications for Australia. 32 Apr 35

In recent trials in The Gambia, mass chemoprophylaxis with Maloprim administered over several years by primary health care workers to children aged 3-59 months has reduced both mortality and morbidity without inducing impairment of natural immunity or significant development of drug resistance. Taking expenditure of both time and money, by both public authorities and village volunteers, into account, the costs and the cost effectiveness of such mass chemoprophylaxis are estimated here. The cost per child protected per season was (1990 US) $2.84; the cost per childhood death averted was $143. Both costs compare favourably with those of permethrin bed net impregnation. So in some circumstances where malaria is holoendemic, control of childhood malaria by chemoprophylaxis may be more economically efficient than provision of impregnated bed nets.
 ...
PMID:The cost-effectiveness of chemoprophylaxis with Maloprim administered by primary health care workers in preventing death from malaria amongst rural Gambian children aged less than five years old. 128 3

A placebo-controlled chemoprophylaxis trial was carried out in 1980 in 318 semi-immune school children in the Madang area of Papua New Guinea, where there was a high prevalence of strains of Plasmodium falciparum resistant to 4-aminoquinolines. Since prophylaxis with amodiaquine at 5 mg/kg weekly had failed, amodiaquine at a dose of 10mg/kg weekly and Maloprim (half a tablet or one tablet depending on body weight, which gave ranges of dapsone of 1.7-3.3mg/kg and pyrimethamine 0.2-0.4 mg/kg) weekly were tried. Neither regimen was completely successful in preventing parasitaemia, though after 13 weeks of prophylaxis the slide positivity rate was 16% for the amodiaquine group and 2% for the Maloprim group, which was in each case significantly lower than the normal baseline rate in the controls of 42%. Amodiaquine was completely successful in suppressing Plasmodium vivax infections. Breakthrough parasitaemia occurred, with either P. falciparum or P. vivax, in 5% of subjects on Maloprim at some time during the 13-week period of prophylaxis. Significantly more children in both the amodiaquine and Maloprim groups than in the placebo group showed a reduction in spleen size. All groups showed an unexplained fall in haemoglobin level over the study period but the fall was significantly less in both the prophylaxis groups. There was no adverse effect on white cell counts by either drug regimen. Chemoprophylaxis as a component of an integrated malaria control program should not be overlooked, provided that compliance can be maintained. However, in this particular case the principal purpose of the study had been to evaluate the proposed chemoprophylactic regimens in school children before embarking on an intervention study in young children. As a result of this study it was decided not to go ahead with the chemoprophylactic intervention in young children but to adopt an approach based on early presumptive treatment.
 ...
PMID:Chemoprophylaxis against malaria in Papua New Guinea: a trial of amodiaquine and a combination of dapsone and pyrimethamine. 134 Oct 89

An Australian expatriate on regular weekly antimalarial prophylaxis with chloroquine base and Maloprim developed symptomatic Plasmodium vivax infection which failed to respond adequately to 600 mg of chloroquine base. More ominously, a resident of the Highlands region of Papua New Guinea contracted vivax malaria which failed to be cleared by 2400 mg chloroquine base administered over 4 d. Both patients had achieved appropriate blood and plasma concentrations of chloroquine after treatment. Chloroquine-resistant P. vivax is now a clinical fact in Papua New Guinea.
 ...
PMID:Chloroquine-resistant Plasmodium vivax in Papua New Guinea. 144 Jul 63

Over 3 years, researchers randomly assigned more than 1775 pregnant women (many in their 3rd trimester of pregnancy) from 41 villages near Farafenni, The Gambia, to receive either Maloprim (malaria chemoprophylaxis of pyrimethamine and dapsone) or a placebo to determine Maloprim's effects on birth weight and child survival. All births occurred at home. Field workers went to each home as soon as possible after delivery to weigh the newborns. The relative risks for neonatal and infant mortality were 23 for infants weighing less than 2000 gms and 12 for those who weighed at least 2500 gms. While they were 2.1 and 0.8, respectively, for infants weighing between 2000 and 2500 gms. 33.3% of low birth weight infants of primigravidae died compared with 19% of those of multigravidae. Taking Maloprim during pregnancy reduced infant mortality by 18% for infants of primigravidae and only 4% for infants of multigravidae. It reduced neonatal deaths by 42% for infants of primigravidae and by just 6% for infants of multigravidae. These results suggested that health workers should distribute antimalarial medicine to all primigravidae. Chemoprophylaxis along with other malaria control efforts, such as insecticide impregnated bed nets or a malaria vaccine, would protect mothers and their infants.
 ...
PMID:Malaria chemoprophylaxis, birth weight and child survival. 147 10

A randomized, blinded comparison of malaria prophylaxis with dapsone-pyrimethamine vs. placebo was conducted in 166 schoolchildren from Maputo, Mozambique, from February to June 1989. The children, aged 7-12, received 1 tablet of Maloprim (Wellcome, 100 mg dapsone and 12.5 mg pyrimethamine), or half a tablet if they weighed 30 kg. After being tested for malaria parasites, children were started on Maloprim the next day, or if infected, after treatment with sulfadoxine-primethamine for 2 weeks. Drugs were administered weekly, and capillary blood was checked by-weekly. There were 28 Plasmodium falciparum infections among children taking placebos, and none in those given prophylaxis. Hematocrits were unchanged. This is the 1st study of dapsone-pyrimethamine for prophylaxis in a chloroquine-resistant malaria area. Since use of this agent on a massive scale could result in resistance, it is recommended that its use be restricted to target groups such as primigravidas or to narrow time periods such as early stage of epidemics.
 ...
PMID:Efficacy of dapsone with pyrimethamine (Maloprim) for malaria prophylaxis in Maputo, Mozambique. 150 11

383 Thai soldiers on the Thai-Cambodian border were entered into a randomized malaria chemoprophylactic trial. Proguanil (200 mg/day) combined with sulfamethoxazole (1000 or 1500 mg/day) were compared to a standard combination of weekly pyrimethamine/dapsone (Maloprim). Men receiving proguanil/sulfamethoxazole had a significantly lower malaria attack rate than those taking pyrimethamine/dapsone. This was true of both the first five-week phase in which 1000 mg of sulfamethoxazole was used (0.11 vs 0.26; p less than 0.001) and in the second ten weeks in which 1500 mg of sulfamethoxazole was used (0.13 vs 0.30; p less than 0.001). Combined relative efficacy indicated that proguanil/sulfamethoxazole was better than pyrimethamine/dapsone by 64% for Plasmodium vivax and by 38% for P. falciparum. Unenforced compliance as measured by returned pills was greater than 86% in both groups. No serious drug side-effects were observed. Proguanil/sulfamethoxazole may represent a useful chemoprophylactic option in areas of multiple drug-resistant malaria.
 ...
PMID:Proguanil/sulfamethoxazole malaria chemoprophy-laxis on the Thai-Cambodian border. 194 64

Serious adverse reactions during malaria chemoprophylaxis are reviewed. Three drugs considered to have caused serious reactions in recent years are pyrimethamine/sulfadoxine (Fansidar), pyrimethamine/dapsone (Maloprim) and amodiaquine. These reactions are principally independent of dose and cannot be determined during screening for optimal doses. However, host factors may precipitate dose-dependent reactions, some of which could be avoided with improvements in drug licensing. Since serious and life-threatening reactions are relatively rare (between 1:1000 and 1:20,000), Phase I to III trials cannot identify them. Reliance must therefore be placed on Phase IV post-marketing studies, including ongoing reviews of national registers, and specially tailored studies to identify the risk using prescription-event monitoring in high-risk populations. Occasionally, medical-record linkage, case-control and cohort studies may provide supportive data. Although large numbers of travellers must, of necessity, be exposed to a drug before relatively rare reactions are identified, the ascertainment of risk using post-marketing surveillance was prevented by the following five deficiencies: lack of awareness of early alerts, inadequate use of national registers, poor attention to epidemiological and statistical rigour, inadequate verification of denominators, and inadequacy of data records. Recommendations are given for minimizing such errors in the future.
 ...
PMID:Ascertainment of risk of serious adverse reactions associated with chemoprophylactic antimalarial drugs. 220 62

We have reviewed a malaria chemoprophylaxis programme in which Maloprim (pyrimethamine and dapsone) has been administered fortnightly by village health workers (VHWs) to approximately 1500 children each year aged 6-59 months resident in 15 primary health care villages in a rural area of The Gambia over 5 years. Reasonable levels of compliance with chemoprophylaxis have been maintained by many children over this period. this has occurred despite minimal outside supervision and support of the programme. Factors which may have affected the level of compliance in individual villages are identified. Large villages and those where social or political factionalism were evident tended to have low levels of compliance. The attitudes of VHWs and mothers to the programme were determined. Most VHWs cooperated enthusiastically and kept accurate records of compliance, despite receiving no compensation from the villagers for administering chemoprophylaxis. The administration of a drug to prevent illness in children was complementary to the curative service provided by VHWs. The chemoprophylactic was widely acceptable and nearly all mothers stated that the tablets were good for their children's health. However, knowledge of the specific purpose of chemoprophylaxis in the prevention of malaria was limited. Improvements in the programme which may result in higher levels of compliance are discussed.
 ...
PMID:Compliance with malaria chemoprophylaxis over a five-year period among children in a rural area of The Gambia. 223 39

Haematological indices and red cell folate levels (RCF) were measured during two annual surveys in a group of Gambian children aged 3 months-5 years who were participating in a trial of malaria chemoprophylaxis with Maloprim or chlorproguanil given with or without folate supplements. Chlorproguanil was given in an adult dose of 20 mg, Maloprim as one quarter or one half of the adult dose of 25 mg pyrimethamine and 100 mg dapsone. Antimalarials and folate supplements were given fortnightly. About 20% of children had low RCF levels (less than 100 ng/ml). Among children who did not receive supplementation with folate there were no significant differences in mean RCF levels between children who received Maloprim, chlorproguanil or placebo. Among children who received folate supplements, the mean RCF was significantly lower among those receiving chlorproguanil than among the controls. Mean RCF values were similar in children who received Maloprim or placebo. If chlorproguanil is used for malaria chemoprophylaxis in young children an age-related dose should be used.
 ...
PMID:The effects of antimalarials and folate supplements on haematological indices and red cell folate levels in Gambian children. 245 31


1 2 3 4 5 Next >>