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)

The study was carried out in 89 uncomplicated falciparum malaria adult cases admitted to Paholpol-Phayuhasena Hospital, Kanchanaburi Province, Thailand, during July 1979 and March 1980. The patients were divided alternatively into 2 groups. Group I, 46 patients, were treated with a single dose of 1000 mg sulfalene and 50 mg pyrimethamine (2 tablets of Metakelfin). Group II, 43 patients, were treated with 1000 mg sulfadoxine and 50 mg pyrimethamine (2 tablets of Fansidar). The parasitemia was cleared within 7 days in 7 cases (15.2%) of group I and in 11 cases (25.6%) of group II. The results of both groups are not statistically significant. It is concluded that the success rate of Fansidar in the treatment of falciparum malaria is decreasing in Thailand and Metakelfin can be used in the treatment of falciparum malaria either alone in mild cases or in combination with quinine as an alternative to Fansidar.
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PMID:Treatment of falciparum malaria with sulfalene-pyrimethamine versus sulfadoxine-pyrimethamine. 701 94

Fifty-eight Nigerian children with Plasmodium falciparum malaria were allocated randomly into two groups and treated with either chloroquine (25 mg/kg over three days) or Fansidar (35 mg sulphadoxin (+ 1/20 pyrimethamine) per kg single dose)). They were observed for 28 days during which blood films were examined periodically for malaria parasites. Asexual forms of P. falciparum, which were present in the blood films of all the patients in both groups before commencing treatment, disappeared rapidly from the blood so that by the fourth day after starting treatment no parasites were seen in the blood films. The blood films thereafter remained negative in both groups throughout the rest of the 28-day observation period. The rate of fever clearance was also similar in both groups. The study did not show resistance to Fansidar or to chloroquine. There is therefore, at present, no case for the indiscriminate use of Fansidar on the basis of suspected chloroquine resistance.
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PMID:The in vivo sensitivity of Plasmodium falciparum to chloroquine and to sulphadoxine-pyrimethamine combination in Ibadan, Nigeria. 703 38

At present the basic antimalarial drugs are still the 4-aminoquinolines chloroquine and amodiaquine, the combinations of antifol compounds (such as pyrimethamine and sulfadoxine = Fansidar), and quinine. In South East Asia and parts of Latin America Plasmodium falciparum has become highly resistant to chloroquine, and increasingly so to the antifol combinations. By selecting the antimalarials bearing the lowest risk of resistance, or combinations of them, an attempt can be made to avoid failures of treatment and chemoprophylaxis. The other areas endemic for malaria tropica may still be generally considered "chloroquine sensitive", although sporadic low-grade resistance to chloroquine is reported. It would be a mistake to replace chloroquine systematically by antifol combinations in those parts of the world now as well. The questions when drug resistance is to be suspected, and how individual treatment can be adjusted to it, are likewise discussed. Mefloquine is the best known new compound, with excellent activity against multiresistant Plasmodium falciparum. A combination with Fansidar is now being developed to prevent the former from inducing resistant strains. Despite considerable experimental advances a malaria vaccine is unlikely to be generally available before the end of this decade.
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PMID:[Current therapy and prevention of malaria and perspectives for the future]. 704 Dec 53

A case of Plasmodium falciparum malaria resistant to chloroquine occurring in a patient taking Fansidar (a combination of pyrimethamine and sulphadoxine) regularly as prophylaxis is reported. It seems likely that the malaria infection was acquired in Tanzania. It is probable that more such cases will be seen, and complacency regarding the emergence of drug-resistant P. falciparum malaria should be guarded against. It is predicted that chloroquine and Fansidar resistance will be increasingly found in a wider area of Africa, including South Africa. A brief review of drug-resistant P. falciparum malaria is presented and alternative therapy discussed.
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PMID:Drug-resistant malaria in Africa. A case report and review of the problem and treatment. 704 5

109 (9.8%) of 1103 malaria patients examined in Sabah were deficient in glucose-6-phosphate dehydrogenase (G6PD). 69 of these G6PD-deficient patients were randomly allocated to 1 of 3 treatment regimes with chloroquine, chloroquine and primaquine, or sulfadoxine-pyrimethamine (Fansidar). No hemolysis was observed in the 1st group; except for a single mild case, no case of hemolysis was seen in the 3rd group. However, in the 2nd group of 23 patients, hemolysis occurred in 7 of 16 patients who had complete G6PD deficiency. Of these 7, 5 required blood transfusion and the other 2 developed acute renal failure, 1 even requiring peritoneal dialysis. In the Fansidar group, 4 of 22 patients took more than 15 days to clear the parasitemia. Chloroquine resistance to falciparum infection was common in the patients given this antimalarial drug.
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PMID:The treatment of malaria in glucose-6-phosphate dehydrogenase deficient patients in Sabah. 732 35

The demographic and clinical features of severe malaria in children on the south coast of Papua New Guinea have never been clearly documented. This prospective study sought to define the associations between ethnic origin, domain, age, nutritional status and severe malaria in this group and to assess significant clinical features, evaluate the use of a coma score as a prognostic indicator in cerebral malaria and to determine the ultimate outcome. Twenty patients with severe malaria (17 cerebral malaria and 3 severe anaemia) were studied. Their mean age of 4.96 years was significantly greater than that of matched controls with uncomplicated. Plasmodium falciparum infection with mean age 3.79 years (0.02 < p < 0.05). Nutritional status was not a significant independent risk factor when controlled against inpatients with other diagnoses. Low coma scores (Adelaide scale 4/14 or less) sensitively predicted the risk of dying vs survival. The mortality of 18% was comparable with other series. Current standard treatment with quinine and Fansidar was effective and no early recrudescence was encountered in the survivors. The degree of intermarriage and migration between regions precluded firm conclusions from being drawn as to the relevance of ethnic and geographical factors in the epidemiology of severe malaria in this region.
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PMID:Severe malaria in children at Port Moresby General Hospital, Papua New Guinea. 748 99

Sulphur-based antimalarial drugs targeted at dihydropteroate synthetase (DHPS) are frequently used in synergistic combination with inhibitors of dihydrofolate reductase (DHFR) to combat chloroquine-resistant malaria. We have previously shown that lines of Plasmodium falciparum resistant to the most commonly used sulpha drug, sulphadoxine, carry point mutations in the DHPS coding region, relative to the sequence of sensitive strains (Brooks et al., Eur. J. Biochem. 224 (1994) 397-405). We have now developed PCR diagnostic assays based on allele-specific amplification that are able to detect such mutations. The four tests described can reliably discriminate all of the mutations observed to alter codons 436, 581 and 613, yielding allele-specific amplification products of different sizes in each case. Moreover, by careful adjustment of primer length and the degree of mismatch to target and non-target alleles, we were able to standardise all four tests to a single set of PCR conditions, allowing all possible mutations to be monitored simultaneously on one thermocycler. These assays should prove invaluable in further assessing the contribution of specific base changes in the DHPS gene of the parasite to the sulphadoxine resistance phenotype and to the clinical failure of the sulphadoxine/pyrimethamine combination Fansidar.
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PMID:A mutation-specific PCR system to detect sequence variation in the dihydropteroate synthetase gene of Plasmodium falciparum. 763 Mar 75

A hospital-based cross-sectional study was conducted in Dar es Salaam, Tanzania, using a questionnaire to assess the extent of self-medication with antimalarial drugs and malaria treatment-seeking behaviour among patients attending out-patient treatment at Mnazi mmoja dispensary. It was found that 15.3% of respondents admitted to having ever used malaria chemoprophylaxis while 8.0% reported to be current users of chemoprophylaxis. Among the current users of malaria chemoprophylaxis, some reported having used quinine and Fansidar. While 71.7% reported having treated themselves with home-kept antimalarial drugs for a suspected malaria fever, 14.7% consulted traditional healers. The data suggest the need for increasing public awareness on malaria and appropriate use of antimalarial drugs.
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PMID:Self-medication with antimalarial drugs in Dar es Salaam, Tanzania. 774 29

In Viet-nam, malaria rages in mountainous and wooded areas, as well as in coastal areas. In these geographical zones, the diversified features of environment have different repercussions on the development of Anopheles species. The main vector species have strict oecological requirements: An. dirus, disseminated in the forests, colonizes stagnant and shaded water, such as rain water collected in ground dips and in cavities of trees and rocks; An. minimus selects its breeding-sites in pure and slightly current streamlets, in the hilly areas. On the contrary, An. sundaicus, first-rate coastal vector, adjusts itself to diversified biotopes, which nevertheless all have common features: saltiness of water (optimum 1-7 g NaCl/litre), faint sunning, stagnant or slightly current water, with floating green algae (Ceratophyllum, Najas). P. falciparum prevails in the wooded areas (P. f.: 75%; P. v.: 25%); but in the coastal areas where Anopheles hyrcanus pullulates, P. vivax reaches the same ratios as P. falciparum. In Viet-nam, the prevention and antimalarial fight are centred on three measures: diagnosis, treatment and watching of diseases, antivectorial fight, antimalarial fight combined with first medical care. Owing to the spreading of P. falciparum chemoresistance to chloroquine (27 to 76%) and to Fansidar (22 to 83%), we had to have recourse to new antimalarials: artemisinine and artesunate tested in several regions of the country (tests in vitro and in vivo during 28 days) revealed their high schizonticidal capacity, but the recrudescence reached 30 to 50%.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Malaria in Vietnam. Environment, prevention and treatment]. 781 9

A reversed-phase high-performance liquid chromatographic method using acetonitrile-methanol-(1M) perchloric acid-water (30:9:0.8:95, v/v/v/v) at a flow of 1.5 ml min-1 on mu-Bondapak C18 column with UV (254 nm) detection has been developed for the separation of sulphadoxine, sulphalene and sulphamethoxazole from other antimalarials. Calibration curves were linear in the range 0.5-100 micrograms ml-1. The limit of quantitation was 50 ng ml-1. Within-day and day-to-day coefficients of variation averaged 2.1 and 6.45%, respectively. The extraction recovery of sulphadoxine from plasma, red blood cells and whole blood was 90.28, 92.05 and 94.69%, respectively. The method has been used for the determination of sulphadoxine concentrations in plasma, red blood cells and whole blood of eight healthy and 50 Plasmodium falciparum malaria cases after administration of two tablets of Fansidar. Mean sulphadoxine concentration in plasma was higher than red blood cells or whole blood. Sulphadoxine concentration in plasma and whole blood of P. falciparum malaria cases was significantly higher as compared to healthy volunteers while it was the same in red blood cells. Sulphadoxine was absorbed much less in red blood cells than in plasma or whole blood.
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PMID:Sulphadoxine concentrations in plasma, red blood cells and whole blood in healthy and Plasmodium falciparum malaria cases after treatment with Fansidar using high-performance liquid chromatography. 784 Dec 29


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