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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.
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PMID:Chloroquine-resistant falciparum malaria from Papua New Guinea and its implications for Australia. 32 Apr 35

Patients with falciparum malaria were studied in Thailand, an area of known chloroquine resistance. The patients were unselected and some had severe malaria, and they were randomly assigned to one of two sequential regimes. A short course of quinine (average 4 doses, equivalent to 2 g base) followed by a single dose of pyrimethamine-sulfadoxine (Fansidar) cured 92% of patients (36 out of 39), while a short course of quinine followed by a single 1-5-dose of mefloquine cured all of the 35 patients who could be followed up. Gastrointestinal side effects were minimal if at least 12 hours elapsed between the last dose of quinine and the mefloquine. Sequential quinine and mefloquine is the most effective treatment for patients with chloroquine-resistant falciparum malaria, including those with severe or complicated disease. Mefloquine, however, is not commercially available, and the similar regimen using Fansidar is almost as effective.
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PMID:Sequential treatment with quinine and mefloquine or quinine and pyrimethamine-sulfadoxine for falciparum malaria. 32 37

The effect of pyrimethamine and the combination of pyrimethamine-sulfadoxine (Fansidar) upon the termination of the acute attack of vivax malaria was studied in Thailand. Pyrimethamine was found to be ineffective, providing clearance of parasitaemia in only two of six patients by the end of seven days following treatment. The combination, administered in a two-tablet single dose (sulfadoxine 1 gm, pyrimethamine 50 mg) eliminated parasitaemia in only six of ten patients within seven days. Three tablets (sulfadoxine 1 . 5 gm, pyrimethamine 75 mg) given to 11 patients, provided clearance of parasitaemia in all within seven days; however, mean parasite and fever clearance times in this group were prolonged at 90 and 50 hours respectively. Chloroquine remains the drug of choice for the termination of the acute attack of vivax malaria. Subsequent primaquine is necessary for the prevention of relapse.
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PMID:Treatment of vivax malaria with sulfadoxine-pyrimethamine and with pyrimethamine alone. 37 85

A case of chloroquine-resistant Plasmodium falciparum malaria in a non-immune male is reported. Primary attack came 19 days after return to a non-malarious country from a visit to Kenya. Recrudescences occurred three times with intervals of 30 to 33 days after standard chloroquine treatment. The WHO extended field test for sensitivity of falciparum malaria to chloroquine was followed by recrudescence 31 days later. Treatment with Fansidar terminated the infection. If continuous treatment of the patient with lithium does not interfere with the schizontocidal action of chloroquine, this strain shows a resistance pattern of R I delayed recrudescence.
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PMID:Chloroquine-resistant Plasmodium falciparum malaria in Kenya. 38 68

In April of 1977 an outbreak of falciparum malaria occurred among the Mayongong Indians, located at Uauaris in the Territory of Roraima, Brazil. Blood specimens from 157 Indians were examined for Plasmodium; 62 were found to be infected. In three cases the infection was not cured with chloroquine but responded favorably to the drug combination of sulfadoxine and pyrimethamine (Fansidar).
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PMID:Drug-resistant falciparum malaria among the Mayongong Indians in the Brazilian Amazon. 38 18

Quinine (at least four doses given at intervals of eight to 12 hours) followed by a single dose of sulfadoxine-pyrimethamine (Fansidar) is the most effective treatment of chloroquine-resistant falciparum malaria. This regimen cured 96% of patients (302 out of 314) with an average initial parasite count of 90 X 10-9/1.
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PMID:Falciparum malaria cured by quinine followed by sulfadoxine-pyrimethamine. 109 10

At a time when Fansimef, the fixed combination of mefloquine, sulfadoxine and pyrimethamine was considered for prophylaxis of falciparum malaria, a randomized double-blind study comparing the efficacy and tolerability of Fansimef with that of Lariam (mefloquine), Fansidar, chloroquine and placebo in malaria prophylaxis was performed in Thailand from July 1987 to January 1988. The study population of 602 adult males was recruited in Pak Tongchai District, some 360 km North-East of Bangkok, where multiresistant P. falciparum is endemic. All active treatments and placebo were given once weekly for 24 weeks with doses as follows: Fansimef: 125 mg mefloquine + 250 mg sulfadoxine + 12.5 mg pyrimethamine (1 half-strength tablet); Lariam: 125 mg mefloquine (1 half-strength tablet); Fansidar: 500 mg sulfadoxine + 25 mg pyrimethamine; chloroquine; 300 mg. A loading dose of 2 half-strength tablets was given in the Fansimef group in weeks 1 and 2 and in the Lariam group in weeks 1 to 4. The incidence of acute episodes of P. falciparum per 100 person months of prophylaxis was 0.17 each in the Fansimef and the Lariam groups, 1.18 in the Fansidar group, 0.69 in the chloroquine group and 0.64 in the placebo group (differences statistically not significant). Clinically adverse events were reported by 170 subjects (Fansimef 28, Lariam 29, Fansidar 41, choroquine 43, placebo 29; differences statistically not significant). The most frequent adverse events in all groups were headache, sleepiness, dizziness and weakness.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Fansimef for prophylaxis of malaria: a double-blind randomized placebo controlled trial. 129 89

From July 1987 to June 1988 a randomized, double-blind, comparative placebo-controlled field trial was conducted in a group of villages near Ibadan, Nigeria. The aim of the study was to assess the suppressive tolerability and efficacy of four antimalarials (Fansimef, Lariam, Fansidar, chloroquine) given for 24 weeks. Fansimef and Lariam were given with loading and maintenance doses, Fansidar and chloroquine as one tablet per week for 24 weeks. Of 567 enrolled subjects, 114 (20%) had parasitaemia on entry. Eight episodes of symptomatic falciparum malaria occurred during the trial, seven in the placebo group, and one in the Fansimef group. Compared with placebo, parasitaemia was effectively suppressed by all four drug regimens. Adverse event data were not significantly different between groups: six adverse events per 114 participants in the Fansimef group, six/113 in the mefloquine group, five/111 in the Fansidar group, 17/115 in the chloroquine group and eight/114 in the placebo group. Safety of Fansimef for 24 weeks in endemic areas was comparable for standard antimalarials in this trial and provides support for the use of this drug for the treatment of resistant malaria in indigenous African populations.
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PMID:Mefloquine-sulphadoxine-pyrimethamine (Fansimef, Roche) in the prophylaxis of Plasmodium falciparum malaria: a double-blind, comparative, placebo-controlled study. 130 98

The management of acute malaria consists of chemotherapy aimed at restoring the normal function of all organs. Appropriate treatment is dependent upon extensive knowledge of the drug sensitivity patterns of the malaria parasites in the area. This is also important for chemoprophylaxis. Drug sensitivity patterns and recrudescence rates for Mongu (Western Province in Zambia) are suggestive of a likely increase in resistance to both chloroquine and sulfadoxine-pyrimethamine (Fansidar). We found RI (19.4%), RII (1.5%) and RIII (4.4%) resistance to chloroquine and RII (4.3%) resistance to Fansidar. This calls for careful consideration of treatment schedules, legislation pertaining to the distribution of drugs in the general public and alternative antimalarial control strategies.
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PMID:Antimalarial drug sensitivity patterns in the western province of Zambia. Implications for the management of primary health care (PHC). 145 23

At the antenatal clinic of Kilifi District Hospital in the Coast Province of Kenya, researchers enrolled 300 pregnant volunteers 15-32 years olds, living in the district to screen and treat then for Plasmodium falciparum infection and to follow those with parasitemia on days 0, 1, 2, 14, 17, 21, and 28. They also conducted in vitro studies to determine resistance to chloroquine. They combined in vivo and in vitro study took place between November 20, 1988 and January 17, 1989. 65 women (21.7%) had P. falciparum in their peripheral blood smear. Primigravidae were more likely to be parasitemia than were multigravidae (41.8% vs. 17.1%; p .001). Their mean parasite density was also higher but not significantly so. Parasite density fell consistently with rising parity. Malaria infections in 54.1% of the women responded to 25 mg/kg chloroquine. the remaining 45.9% (28) of cases exhibited in vivo resistance, especially at RI an RII levels (36.1% and 8.2%, respectively). Primigravidae were more likely to experience failure to clear parasites by day 7 than multigravidae. Further, among women experiencing a parasitemia on day 7, parasites tended to reappear on day 14 and 21 in primigravidae. Initial parasite density did not affect clearance of parasites. Primigravidae continued to have a higher level of parasitemia throughout treatment than did multigravidae. It took at least 24 hours for the chloroquine to be completely absorbed thus the mean level of parasitemia decreased sharply between 0-2 days. Amodiaquine induced a parasitemia in 89.3% (25 cases) of the chloroquine resistant infections. Even though the 3 remaining cases with parasitemia received amodiaquine treatment, clinicians administered Fansidar, resulting in a clearing of parasitemia in 7 days. 34.8% of in vitro parasite cultures were resistant to chloroquine. The reduced ability of pregnant women to clear parasitemia likely explained the lower level of in vitro resistance.
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PMID:In vivo and in vitro response of Plasmodium falciparum to chloroquine in pregnant women in Kilifi district, Kenya. 150 11


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