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)

An American Peace Corps volunteer contracted chloroquine-resistant Plasmodium falciparum malaria while serving in Malawi and taking regular chloroquine prophylaxis. Resistance was confirmed by in vitro testing of his parasites for chloroquine and pyrimethamine. The possibility of Fansidar-resistant falciparum malaria was also suggested in this case. American expatriates residing in or traveling to Malawi are advised to either take both chloroquine and Fansidar, or alternatively amodiaquine or doxycycline alone. Any breakthrough of slide-proven falciparum malaria in these individuals should be seriously suspected to be chloroquine- and Fansidar-resistant malaria, and should be treated with quinine and tetracycline.
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PMID:Chloroquine-resistant falciparum malaria in northern Malawi. 389 84

A double-blind, randomized phase I clinical trial was carried out to compare Fansimef (a fixed-dose combination of mefloquine, sulfadoxine, and pyrimethamine) with sulfadoxine and pyrimethamine (Fansidar) for safety and tolerance. Twenty adult male Brazilian subjects from malaria endemic areas were studied for a period of 66 days, which included 2 days before and 63 days after drug administration.Both drugs were well tolerated and safe, as seen from the absence of drug-induced changes in the various laboratory, haematological, and biochemical parameters measured. Fansimef produced a complete clearance of parasites on day 3, with an "S" type response in one subject who had blood smears which were positive for Plasmodium falciparum on day 0. Two subjects in the sufladoxine-pyrimethamine group also had P. falciparum infections on day 0; the parasitaemia was cleared on day 2 in one of these subjects and on day 3 in the other, but an early RI response (recrudescence) was observed in the former case. Relapses due to P. vivax occurred in both groups.Side-effects due to Fansimef included mild dizziness, nausea, and vomiting. The incidence of dizziness and nausea was similar in the sulfadoxine-pyrimethamine group. In both groups, these side-effects were mild, short-lived and did not require specific treatment. Thus, Fansimef in an oral dose of three tablets (total of 750 mg mefloquine (base) plus 1500 mg sulfadoxine plus 75 mg pyrimethamine) was found to be well tolerated and safe.
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PMID:A phase I clinical trial of Fansimef (mefloquine plus sulfadoxine-pyrimethamine) in Brazilian male subjects. 389 98

Malaria was studied in the province of Takeo, Cambodia. In the hyperendemic region of Kirivong district, 49 (46.0%) of 105 suspected patients were found to be infected, 98% of them with Plasmodium falciparum and 2.0% with P. vivax. The highest prevalence (85.7%) was recorded in the group of 15-20-year-old patients. A total of 296 patients were examined in the hospital of Takeo during one year (1983-1984) and 77 (26.0%) of them were positive. P. falciparum infection was found in 76.6% and P. vivax in 23.4% of cases. The highest prevalence (42.3%) was also in the age-group of 15-20 years. The "7-day test" was used in vivo in 15 patients in order to detect the sensitivity of P. falciparum to Fansidar. The asexual forms of parasites disappeared within 4 days, while the gametocytes survived in two patients until 7th and 8th day, respectively. The observations could not be terminated, since the two patients will fully left the hospital.
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PMID:Malaria in the province of Takeo, Cambodia. 389 74

The case is reported of a 40-year-old woman who developed an eosinophilic lung infiltration during malaria prophylaxis with pyrimethamine-sulfadoxine (Fansidar). The patient had a severe condition with cough, fever, chills, dyspnea, weight loss and an unusual but characteristic radiologic picture. Corticosteroid medication was followed by a dramatic improvement in symptoms and complete resolution of the radiographic opacities within a few days. There was no recurrence after cessation of steroids. The authors believe that the cause of this lung disease was an allergic reaction to pyrimethamine-sulfadoxine (Fansidar). Some aspects of drug-induced eosinophilic pulmonary infiltrations are discussed.
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PMID:[Eosinophilic lung infiltration during malaria prophylaxis with pyrimethamine-sulfadoxine (Fansidar)]. 404 13

A trial of drug regimens for treating Plasmodium falciparum malaria was conducted in a refugee camp in eastern Thailand where extensive 'Fansidar' (pyrimethamine-sulfadoxine) resistance had been demonstrated. The efficacy of quinine alone was compared to that of quinine combined with either fansidar or tetracycline. Quinine alone cleared the parasitaemia in 57 of 59 patients but failed to cure approximately one-third of these patients after 7 or 10 days of therapy. The addition of fansidar to quinine therapy did not significantly improve the overall cure rate. Tetracycline given for 10 days in combination with quinine cured all patients, suggesting that tetracycline should be considered in treating patients with falciparum malaria contracted in the area of the Thai-Kampuchean border.
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PMID:Drug therapy for Plasmodium falciparum malaria resistant to pyrimethamine-sulfadoxine (Fansidar). A study of alternate regimens in Eastern Thailand, 1980. 611 22

The malaria infection rates in non-immune residents of Dar es Salaam on various chemoprophylactic regimens were compared with that (37.1%) in those not taking prophylactic antimalarials. Among 647 people resident in Dar es Salaam for 1-6 years the two groups with the lowest infection rates by person-episodes (2.0% and 1.5%) were those taking proguanil 200 mg daily alone or with chloroquine base 300 mg weekly. Infection rates (16.9% and 14.0%) were also significantly lower than in the no-prophylaxis group in those taking chloroquine base 300 mg weekly combined with 'Fansidar', 'Maloprim' (each one tablet weekly), or proguanil 100 mg daily. No significant reduction in the malaria attack rate was found in those taking chloroquine base 300 mg or 600 mg weekly (31.2%), pyrimethamine 25 mg weekly (27.3%), proguanil 100 mg daily (46.4%), maloprim one tablet weekly (40.4%), or a combination of chloroquine base 300 mg weekly and pyrimethamine 25 mg weekly (27.1%). Similar results were obtained when the infection rates per year of exposure were compared. Proguanil was associated with fewest user complaints and fansidar with most.
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PMID:Chemoprophylaxis of malaria in non-immune residents in Dar es Salaam, Tanzania. 614 92

A prospective trial in 80 patients randomly allocated to four antimalarial treatment regimens--mefloquine plus pyrimethamine-sulfadoxine ('Fansidar'); mefloquine plus qinghaosu; mefloquine, fansidar, and qinghaosu; and qinghaosu alone--was carried out on Hainan Island, China, in patients with chloroquine-resistant falciparum malaria. A radical cure with slight side-effects was obtained with mefloquine plus fansidar; the addition of qinghaosu greatly increased the rate of parasite clearance with no additional side-effects. Qinghaosu alone had a rapid rate of parasite clearance, no side-effects, but a high recrudescence rate. These antimalarial drugs seem to act at different stages of the asexual parasite cycle and their most efficient use may depend on when in the course of the disease they are given. Because of the continuing appearance of drug-resistant strains of Plasmodium falciparum combination drug therapy is now indicated, but which drugs and how best they should be used remains to be decided.
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PMID:Randomised comparative study of mefloquine, qinghaosu, and pyrimethamine-sulfadoxine in patients with falciparum malaria. 615 Mar 65

Malaria prevention is a main challenge for physicians, nurses, health officers and tour operators. The attack rate of malaria in travellers is 1-10/10,000 departures, and the case fatality rate of imported malaria is around 0.5/100. Travellers should be informed about the risk they are going to take, how to protect against mosquito bites, about the antimalarials they will have to take and what to do when a malaria breakthrough should occur. The 4-aminoquinolines (chloroquine, amodiaquine) remain the drug of choice for the prevention of Plasmodium vivax and of sensitive P. falciparum infections. The problem is to find an effective and safe drug combination for travellers to areas where P. falciparum is either resistant to chloroquine, to Fansidar (the combination of pyrimethamine plus sulfadoxine) or to both. These travellers will probably best be protected by an individually tailored drug combination, which includes amodiaquine or mefloquine as baseline drugs, and a supplementation with Fansidar, Maloprim (the combination of pyrimethamine with dapsone), paludrine or an antibiotic.
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PMID:Malaria prophylaxis in travellers: the current position. 615 Aug 65

A randomized double-blind study was performed to compare the side effects of long-term chemoprophylaxis of malaria with Fansidar (1 tablet a week) with those of a 300-mg weekly chloroquine regimen. This study was designed as a field trial with Austrian industrial workers in Nigeria and included 173 volunteers, 86 taking Fansidar and 87 taking chloroquine for 6 to 22 months. Only a few complaints were reported during that time, gastrointestinal disorders predominating in the Fansidar group and insomnia in the chloroquine group (3 cases each). The other complaints in both groups included one case each of skin rash and of visual disturbance, as well as one case of facial erythema after alcohol consumption in the Fansidar group and one of hair loss in the chloroquine group. Laboratory checks were performed at 3-monthly intervals, and included white and red cell counts, platelet counts and determination of GOT, GPT and alkaline phosphatase. There were no signs of drug-associated liver damage. In the Fansidar group there occurred a slight and transient decrease in the red cell count and in the chloroquine group a slight and transient decrease in the white cell count. Although statistically significant, these changes were without clinical significance. It is noteworthy that there were no cases of leucopenia in the Fansidar group. With the exception of one volunteer, who had discontinued his prophylactic drug regimen, malaria did not occur. Antibodies against blood stage parasites as determined by the indirect immunofluorescence test (IIFT), however, could be found at different stages of the study, which indicates that these two antimalarials are not causal prophylactic agents.
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PMID:Tolerability of long-term prophylaxis with fansidar: a randomized double-blind study in Nigeria. 615 20

A decreased chloroquine (Resochin) sensitivity of strains of Plasmodium falciparum in certain areas of East Africa has given rise to an inappropriate change of chemoprophylaxis to pyrimethamine-sulfadoxine (Fansidar). Falciparum malaria occurred in five tourists during or after Fansidar prophylaxis. A therapeutic chloroquine-R2-resistance was observed in one seriously ill patient. In some patients the course of disease was prolonged to such an extent that the diagnosis could be established only after as much as 4 months after the end of the journey. This was in part surely caused by intake of anti-plasmodial drugs such as sulfonamides, tetracyclines and co-trimoxazol. The high mortality of falciparum malaria of nearly 10% in this country does not depend on the choice of drug prophylaxis or on problems of resistance, but still on a missed or delayed diagnosis.
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PMID:[Falciparum malaria in East African tourists in spite of fansidar prevention. A contribution on increased chloroquine and pyrimethamine-sulfadoxine resistance in areas of East Africa]. 633 9


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