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Query: UMLS:C0024530 (malaria)
 44,886 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Malaria treatment of children is particularly difficult because of the absence of palatable suspensions for young children. Halofantrine hydrochloride is available as a suspension which is both palatable and simple to administer, and has been studied in a number of trials in the past 5 years. Children (331) ranging from 4 months to 17 years of age (mean 4.7 years) were treated with the 5% suspension using various dose regimens and 364 children ranging from 4 months to 14 years of age (mean 5.7 years) were treated with the 2% suspension 6 hourly for 3 doses. Using the 3-dose regimen there were only 2/462 (0.4%) who failed to clear the initial parasitaemia. Recrudescence occurred in 28/367 (7.6%) children with evaluable follow up data. The mean parasite clearance time in this group was 57.1 h (n = 417) and the mean fever clearance time was 50.9 h (n = 325). Symptoms related to malaria cleared rapidly following treatment generally by 24-48 h post treatment. Side effects possibly related to treatment were uncommon but were similar to those reported in adults. The frequency of diarrhoea and abdominal pain was lower than that seen in adults and was also less frequent following multiple doses and the use of the more dilute suspension. Since there was evidence that the majority of recrudescences were seen in younger children or those living in areas with low or seasonal transmission it is recommended that a further course of treatment 7 days later is given to these patients to prevent recrudescence.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The treatment of falciparum malaria in children with halofantrine suspension. 134 99

Thirty two children with symptomatic malaria due to P. vivax and P. Falciparum infections were treated with three doses of Halofantrine hydrochloride 8 mg/kg body weight every 6 hours. Mean fever clearance was 30 hours (range 24-48 hours). No significant clinical or biochemical side effects were observed. Symptoms cleared rapidly. Halofantrine hydrochloride was found to be highly effective and appeared to have no side effects in children with acute malaria infections.
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PMID:Halofantrine hydrochloride--efficacy and safety in children with acute malaria. 190 May 50

Halofantrine hydrochloride (HF) belongs to a new class of antimalarials, the phenanthrene methanols. Preliminary clinical studies suggested that an adult dose of 500 mg 6-hourly for three doses, with a weight-based regimen of 8 mg/kg 6-hourly for three doses in children, would be effective. In an ongoing clinical programme, 1973 patients with acute malaria were analysed, of whom 1474 (1315 with P. falciparum and 122 with P. vivax malaria) received the above regimen. In the studies 931 adults and older children were treated (61 with capsules and 870 with tablets) while 520 infants and young children used 5% or 2% suspension. The majority of studies were performed in areas of high chloroquine or multidrug resistance. Only eight (0.6%) of 1282 evaluable patients with falciparum malaria failed to clear their parasitaemias within 7 days. Recrudescence of parasitaemia occurred in 77 patients (6.0%). Reinfection cannot be excluded in several of the cases, where protection from malaria transmission was not maintained. The majority of recrudescent patients were either non-immune (normally residing in malaria-free areas) or were infants below 2 years of age. In vivax malaria cases, there were six recrudescences (5.4%). The mean parasite clearance time was 57.9 h and the fever clearance time 50.2 h in falciparum malaria cases, while the clearance times for vivax cases were 57.3 h and 49.6 h respectively. Clinical events were uncommon and consisted of mild transient diarrhoea or abdominal pain in less than 5% of cases. Laboratory findings were generally abnormalities related to the acute disease rather than drug treatment. Experience to date would indicate that HF is a safe and useful drug for the treatment of acute malaria, particularly in areas where there is extensive resistance to current antimalarials.
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PMID:Clinical experience with halofantrine in the treatment of malaria. 210 Jul 32

Twelve children, 2 to 15 years of age, with falciparum malaria (parasitaemia 4,500 to 170,000/mm3) have taken 24 mg/kg body weight of halofantrine hydrochloride (Halfan) per os in three divided doses given within 12 hours. The symptomatology improved after 24 to 48 hours, with no more fever 5 to 90 hours after treatment and with a decrease of splenomegaly in 80% of the cases. The parasitic clearance was obtained after 24 to 60 hours. The haematocrit started raising again in 58% of the cases. Halofantrine hydrochloride is an efficient antimalarial drug in semi-immune patients. It is well tolerated and well accepted, thus representing an alternative for the cure of chloroquine-resistant falciparum malaria.
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PMID:[Halofantrine in the treatment of malaria. Clinical trial in a semi-rural zone of Cameroon]. 267 Feb 89

Halofantrine hydrochloride given to 46 Kenyan children with falciparum malaria at 10 mg/kg for two doses, and to 60 other children at 8 mg/kg for three doses, resulted in rapid parasite clearance, mean parasite clearance times being 45.4 h and 54.8 h, respectively. In-vitro chemosensitivity tests showed that most infections were due to chloroquine-resistant parasites, and that parasite maturation was inhibited by considerably lower concentrations of halofantrine than of chloroquine.
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PMID:Efficacy of multiple-dose halofantrine in treatment of chloroquine-resistant falciparum malaria in children in Kenya. 289 37

Two clinical trials of the phenanthrene methanol compound halofantrine in the treatment of Plasmodium falciparum were conducted in Malawi, in areas where the parasite was known to be chloroquine resistant. In the first trial all 46 patients had symptoms of malaria and parasite densities ranging from 2500/microliter to 212,000/microliter. They were given a single dose of halofantrine hydrochloride, 16 mg/kg body weight. The recrudescence rate on day 14 of follow up was unacceptably high (38%). In the second trial the dose given was 8 mg/kg 6 hourly for three doses. Of the 49 children followed up for 14 days, 47 became aparasitaemic--ie, the cure rate was 96%. In both trials the drug was very well tolerated. Halofantrine hydrochloride seems to be effective against P falciparum chloroquine sensitive and resistant strains in Africa.
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PMID:Clinical trials with halofantrine hydrochloride in Malawi. 289 38

We report specific dyslipidemia in Gabonese children aged 18 months to 4 years old treated with Halfan for malaria. This is observed in addition to the hypoglycemia typically associated with malaria. C-HDL (high density lipoprotein) fell on day 0 (D0), then increased during the treatment. Triglycerides (TG), total cholesterol (TC) and non-esterified fatty acids (NEFA) rose on D0. CT continued to rise evenly throughout the treatment, whereas TG declined. The differences with respect to normal values are significantly different as assessed by the Student test. We report metabolic variation and tolerance to Halfan.
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PMID:[Lipid profile during specific malaria therapy in Gabonese children]. 778 Jun 73

A 44-year-old male, who had been to Lagos, Nigeria, was admitted to our hospital because of a high grade fever on July 20, 1993. On admission, Plasmodium falciparum was detected in his blood smears and the antibody titers against P. falciparum and Plasmodium vivax antigens were 1:256 and < 1:4 respectively by the indirect fluorescent antibody test. Therefore, he was diagnosed as having P. falciparum malaria. He was treated with halofantrine (Halfan: Smith Kline Beecham Pharmaceuticals, England), two tablets at six-hourly intervals, a total of six tablets (1500 mg). Parasites were cleared rapidly and remission was achieved without any adverse reactions. Halofantrine can therefore be recommended for the treatment of imported P. falciparum malaria.
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PMID:[A case of Plasmodium falciparum malaria successfully treated with halofantrine]. 817 81

In 1992, some 90 countries or territories where 42% of the world's population resided were considered malarious and estimation of deaths from malaria worldwide per year were in the order of 1.4 of 2.8 million. The higher the number of Japanese who go abroad becomes (the total number in 1994 was 13,578,934: Records of Statistical Division of the Ministry of Justice), the greater is the risk of their contracting malaria. Indeed, the reported annual number of imported malaria cases increased to not less than 100. Now, malaria should first be presumed if a patient complains of a higher fever after a visit to a tropical country. And the importance of instituting prompt diagnosis and proper treatment should also be stressed. One of the antimalarials which has been highlighted for its effectiveness is halofantrine. This drug has been used for treatment of human malaria since 1984, and to date clinical trials have involved about 3.4 million patients in more than 30 countries (personal communication). Several patients successfully treated with halofantrine without any treatment failure have also been documented in Japan. However, in 1993, a clinical study involving 400 patients on the Thai-Burmese border revealed cardiac effects of antimalarial treatment with halofantrine, including one sudden death after the treatment. There have also been some spontaneous reports of serious ventricular dysrythmiasis with prolongation of the QT intervals, rarely associated with death. The pharmaceutical company producing Halfan has reported 8 cardiac arrests, leading to 6 deaths, when a higher dose than recommended was used, there was recent or concomitant treatment with mefloquine, there was pre-existing prolongation of the QT interval or the patient had a thiamine deficiency. Finally, the World Health Organization (WHO) announced a "drug alert" on halofantrine advising a change in recommendations for its use. In the present paper, we discuss the first Japanese vivax malaria patient whose QT interval was prolonged after treatment with halofantrine.
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PMID:Prolongation of the QT interval observed in a Japanese patient with vivax malaria following treatment with halofantrine. 858 95

Halofantrine hydrochloride (Hf) is an orally active, highly lipophilic antimalarial indicated for the treatment of multi-drug resistant Plasmodium falciparum. In this study, we have examined the binding profile of Hf to the various classes of human and beagle plasma lipoproteins as such interactions have been implicated in a post-prandial plasma lipoprotein-induced decrease in the total clearance and volume of distribution of Hf. The distribution of Hf within plasma was dominated by interaction with the various classes of plasma lipoproteins, and the characteristics and extent of binding were markedly different between species and between pre- and post-prandial plasma. In an attempt to understand the basis for the differential binding of Hf to the various lipoprotein fractions, the relationship between the proportion of Hf associated with each lipoprotein fraction (as a function of the respective mass of protein, triglyceride, cholesterol, and phospholipid) was investigated. The data indicated that the distribution of Hf between plasma lipoproteins was highly correlated with the apolar lipid load of individual plasma lipoprotein fractions suggesting that the mechanism of association was primarily via solubilization in the lipoprotein apolar lipid core. These data suggest that acute changes in plasma lipoprotein profiles, such as encountered post-prandially or in disease states such as malaria, will likely have an impact on the plasma lipoprotein binding of Hf.
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PMID:Differences in the lipoprotein binding profile of halofantrine in fed and fasted human or beagle plasma are dictated by the respective masses of core apolar lipoprotein lipid. 1005 98


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