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

In different countries opinions differ as to which chemotherapeutic methods should be used for malaria prophylaxis. It has long been the opinion of the Nordic countries, that WHO should give an official recommendation and the result is reflected now in the publication "Vaccination certificate requirements and health advice for internation travel." The malaria-endemic regions of the world are divided into 3 categories: regions without risk and no need for prophylaxis, low risk regions (A) with predominantly vivax inflections, risk regions (B) with predominantly chloroquine sensitive P. falciparum, and high risk regions (C) with often both chloroquine as well as sulfa/pyrimethamine resistance. Chloroquine is a sufficient prophylaxis for A-regions. For B-regions proguanil should be added and for C-regions only mefloquine is given. Proguanil was reintroduced basically because of Swedish research results in Liberia. An American initiative recommends for all regions, A-C, chemorprophylaxis as an alternative. However, a precondition is an observant traveller and clear instructions for self-treatment. Travellers who fall ill in a B-region should choose between Fansidar, mefloquine and quinine for self-treatment. Mefloquine has the least serious side effects, whereas quinine is therapeutically more safe. Fansidar very seldom gives any side effects. For C-regions only mefloquine is recommended for self-treatment. Nordic colleagues have recommended to double prophylaxis (chloroquine + Paludrine) treatment for the entire African tropical region. For short-time travellers to Kenya, Tanzania and Uganda, 6 tablets Lariam should be added. Only chloroquine is recommended for India and the Amazon region of South America. No chemoprophylaxis can guarantee full protection. Insect protection is therefore more important than ever. Malaria decreases the unspecific immune defense system. Surprisingly, repeated tests have shown that the AIDS frequency is not higher in patients with chronic malaria than for persons without plasmodia in the blood. In WHO's new little yellow booklet, a page concerning prophylaxis against AIDS appears. Equipment that is not new should be steamed or cooked for a least 20 minutes or treated with chemical disinfectants for at least 30 minutes. These measures should be enough to prevent HIV-infection.
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PMID:[Malaria and HIV prevention in WHO's "little gem"]. 338 44

Fansidar (SP), a combination of sulfadoxine and pyrimethamine, was evaluated for its usefulness as a curative agent for treating individual malaria patients and for reducing the community reservoir of Plasmodium falciparum in 4 villages near Lahore, Pakistan, where resistance of 4-aminoquinolines has recently been reported. Following the end of the major malaria transmission season, we carried out a month-long mass treatment campaign during which SP was given to all available villagers who had parasitemias detected during a concurrent house-to-house malaria blood film survey. Of the 82 falciparum patients followed for 14 days after SP treatment, 80 (97.5%) had parasites sensitive to the investigated drug. Parasitemia clearance time after SP was remarkedly short (1.25 +/- 0.53 days; mean +/- SD). However, we were unable to reduce the parasite reservoir of P. falciparum and P. vivax in these villages, probably because we treated only 337, about one-third, of the parasitemic patients. We conclude that SP is an effective drug for treating individual malaria patients from areas in Pakistan where 4-aminoquinoline-resistant parasites are present, but that more research is needed for assessing its usefulness in reducing community reservoirs of malaria.
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PMID:Effects of Fansidar on chloroquine-resistant Plasmodium falciparum in Pakistan. 351 52

The effects of chloroquine, amodiaquine and pyrimethamine-sulfadoxine (SP) (Fansidar) on the infection rate and density of Plasmodium falciparum gametocytes were studied in 198 patients with falciparum malaria from an area in the Punjab where malaria is endemic but seasonally transmitted. One month following treatment of 100 patients, SP had reduced the gametocyte carrier rate from 37% to 6% and the mean gametocyte density from 80 to 1.4 per mm3 of blood. Chloroquine and amodiaquine were much less effective. Since SP has no gametocytocidal properties and the reduction in gametocytes coincided with clearance of asexual parasitemias, gametocytes were probably reduced subsequent to the cure of the asexual malaria infections. If used during the nontransmission season, SP might be an effective component of an integrated program for reducing malaria transmission in the Punjab and other areas where 4-aminoquinoline-resistant and SP-sensitive falciparum malaria exists.
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PMID:Effects of chloroquine, amodiaquine and pyrimethamine-sulfadoxine on Plasmodium falciparum gametocytemia. 351 44

Between 1980 and 1985 falciparum malaria was diagnosed in 28 and tertian malaria in 17 patients. Only three of the 35 non-immune patients complied with the appropriate chemoprophylaxis; these three patients nevertheless developed tertian malaria (recurrences caused by "dormant" merozoites). The main drawbacks of chemoprophylaxis were lack of patient compliance (26 out of 35 patients) and inappropriate medical advice (14 out of 35 patients). Initial symptoms developed within one month after the end of exposition in 21 out of 23 patients infected by Plasmodium falciparum, but only in three out of twelve cases of tertian malaria. Risk of infection by Plasmodium falciparum is highest in Africa, while most of the malaria cases in India are caused by Plasmodium vivax. Long-term prophylaxis using pyrimethamine-sulfadoxine (Fansidar) is not advisable as there is a risk of life-threatening side effects.
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PMID:[Malaria prevention. Risk of infection in relation to preventive measures]. 352 80

Seven patients (one black African and six white Europeans) developed chloroquine-resistant falciparum malaria in East Africa. In vitro studies confirmed chloroquine resistance in three patients, but the parasites failed to grow in the other four patients. Six patients were cured by sequential quinine and Fansidar, one by sequential quinine and mefloquine.
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PMID:Chloroquine-resistant falciparum malaria from East Africa. 354 85

Sixty-eight cases of vivax and 30 cases of falciparum malaria patients were treated with a combination of sulfamonomethoxine-pyrimethamine (MP tablet with 500 mg of sulfamonomethoxine and 25 mg of pyrimethamine) and the results were compared with those with chloroquine, Fansidar and quinine. Vivax malaria: Fever and parasites were cleared by the 4th day of treatment in 94 and 92% of the patients, respectively. Chloroquine was the most effective drug and Fansidar and MP tablets shared the next position. Falciparum malaria: Fever and asexual parasites were cleared by the 4th day of treatment in 67 and 78% of the patients, respectively. MP tablets were effective in chloroquine-resistant falciparum malaria contracted in Kalimantan (Indonesia) and Oceanian countries (Vanuatu etc.). Fever and parasite clearance times were shorter with chloroquine or with Fansidar than with MP tablets. Defective preschizonts used to appear following administration of MP tablets both in vivax and falciparum malarias. They were the premonitory laboratory indications that the asexual parasites will be soon eradicated.
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PMID:A combination of sulfamonomethoxine and pyrimethamine versus other drugs for the treatment of malaria. 354 42

The protective effect of malaria chemoprophylaxis with either Fansidar (pyrimethamine-sulfadoxine) or chloroquine was estimated by determining the attack rates of Plasmodium falciparum infections acquired in Kenya and imported by U.S. and Swiss travelers who had used no chemoprophylaxis, who had used only chloroquine for prophylaxis, and who had used Fansidar weekly, either alone or in combination with chloroquine. The estimated attack rates were almost identical in U.S. and Swiss travelers. The attack rate per 100,000 travelers averaged 280 in those who did not use chemoprophylaxis, 162 in those who took 4-aminoquinolines (P greater than .05), and 27 in those who used Fansidar for prophylaxis (P less than .001). Non-immune travelers to Kenya have an appreciable risk of acquiring a P. falciparum infection and need to be informed of current guidelines for chemoprophylaxis. The changing drug susceptibility patterns in Africa require continuous evaluation of the efficacy of recommended drug regimens for malaria prophylaxis.
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PMID:Efficacy of malaria prophylaxis in American and Swiss travelers to Kenya. 355 47

The pharmacokinetics of sulfadoxine (SULF) and pyrimethamine (PYR) were studied in 7 healthy volunteers after a single oral dose of Fansidar. A comparison was made between the pharmacokinetics of the components of Fansidar calculated from whole blood and plasma data. The mean whole blood to plasma concentration ratios of SULF and PYR were 0.62 and 0.87, respectively. The elimination half-lives of SULF and PYR were similar in whole blood and plasma. The apparent volume of distribution and clearance of SULF and PYR in whole blood were significantly higher (p less than 0.01) than the corresponding plasma values. Because malaria-infected erythrocytes appear to concentrate SULF, it may be more relevant to measure drug concentrations in whole blood rather than in plasma in assessing the antimalarial efficacy of Fansidar.
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PMID:Pharmacokinetics of sulfadoxine and pyrimethamine after Fansidar administration in man. 360 21

We report a subject who had Fansidar prescribed to him for the purpose of malaria prophylaxis. This agent is a combination of pyrimethamine and sulphadoxine. He subsequently developed severe hypersensitivity pneumonia and required mechanical ventilation. We believe that sulphadoxine was responsible for his illness.
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PMID:Fansidar hypersensitivity pneumonitis. 365 13

The in vitro effect of pyrimethamine (PYR) on human blood mononuclear cells stimulated with phytohaemagglutinin (PHA), pokeweed mitogen (PWM) and purified protein derivative of tuberculin (PPD) was studied by 14C-thymidine incorporation, by cell counting and by total DNA estimation. PYR in concentrations 10 times higher than serum values obtained in clinical practice inhibited lymphocyte proliferation irreversibly. PYR in concentrations corresponding to clinical practice quickly and irreversibly suppressed the proliferation of PWM-stimulated cells, and more slowly the proliferation of PPD-stimulated cells. The suppression of PHA-stimulated cells was reversed after one week. The increased 14C-thymidine incorporation observed in stimulated cells exposed to PYR in vitro in the early phase of proliferation did not reflect immunopotentiation but rather blocked endogenous thymidine synthesis. Sulphadoxine (SDX), added in vitro, had no effect on the lymphocytes, while SDX plus PYR had the same effect as PYR alone. Oral intake of SDX plus PYR (Fansidar) also blocked the thymidine synthesis of mitogen-stimulated lymphocytes. The possible consequences of the findings for the use of PYR in malaria prophylaxis and therapy are discussed.
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PMID:Effect of pyrimethamine and sulphadoxine on human lymphocyte proliferation. 378 90


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