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

Malaria is largely preventable, so travelers should be taught general protective measures and given appropriate chemoprophylaxis before they leave on their trip. Chloroquine phosphate (Aralen) is still the drug of choice in locations where malaria remains chloroquine-sensitive. However, chloroquine-resistant areas infested with Plasmodium falciparum are becoming more numerous. In such areas, mefloquine hydrochloride (Lariam), doxycycline, or proguanil (Paludrine) (obtainable outside the United States) may be used. A single dose of pyrimethamine-sulfadoxine (Fansidar) may be used to treat presumptive malarial infection if medical care is not immediately available. For prevention of relapse of Plasmodium vivax and Plasmodium ovale infection, primaquine phosphate is recommended for the final 2 weeks of chemoprophylaxis on return from a malarious area.
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PMID:Prophylaxis for malaria. Helping world travelers come home healthy. 151 52

Blood smears of 202 turkeys (94 males and 108 females) in the Nsukka area (Nigeria) were examined for malaria parasites. Among the turkeys examined 44.1% (95% confidence interval, 0.441 +/- 0.069) were infected with Plasmodium spp., 46.8% males and 41.7% females. A total of 175 adults and 27 growing turkeys (aged 6-16 weeks) were examined and 45.7 and 33.3%, respectively were infected. Twenty out of 60 reared turkeys under intensive management systems and 65 of 142 turkeys managed semi-intensively were infected. The mean PCV value for the infected turkeys was 29.95 +/- 3.36% and significantly different (P less than 0.01) from the mean PCV value of 37.3 +/- 3.7 obtained from the uninfected turkeys. Eleven out of the 89 positive cases were clinical cases. Four critically sick turkeys died one day after treatment. Chloroquine phosphate at 5 mg/kg body weight administered i.m daily for 3 days or 250 mg tablets given orally for 5 days as well as a parenteral administration of pyrimethamine (0.3 mg/kg body weight) for 2 days were effective in the treatment of the infection.
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PMID:Prevalence of malaria parasites in turkeys of the Nsukka area in the Anambra State, Nigeria. 184 25

The effectivity of intramuscular Delagil therapy with that of oral treatment in malaria patients are compared. On the basis of the therapeutic results of 8 malaria patients each it has been concluded that the cessation of fever and parasitaemia occur within a somewhat shorter time in the intramuscularly treated patients than in the orally treated ones. Finally, the usefulness of intramuscular Delagil therapy as an antimalarial medication has been assessed. According to the opinion of the author oral treatment has to be preferred in general in uncomplicated malaria cases. The indication fields of intramuscular Delagil therapy are the following: 1. Unconsciousness, cerebral or other complications. 2. High fever, poor general condition requiring rapid action; in the latter two cases the above-mentioned frequent application of lower doses is recommended. 3. Relatively good general condition but abundant vomiting and/or diarrhoea.
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PMID:Intramuscular delagil therapy in malaria. 269 17

Chloroquine phosphate (CP) has been formulated in a suppository base consisting of polyethylene glycol, PEG 1000 and PEG 6000 (7:3) with 0.5% polysorbate 80 included as an absorption promoter. Peak chloroquine blood levels in children (mean body weight 10 kg, age 21 months) were 0.67 +/- 0.08 micrograms/ml (after 200 mg CP) and 1.06 +/- 0.23 micrograms/ml (after 300 mg CP) following rectal administration of the suppositories. Prior to drug administration, the base level chloroquine was 0.30 +/- 0.02 micrograms/ml. Elimination half lives calculated from the rapid phase of log concentration-time curves were 3.3 h (after 200 mg CP) and 2.7 h (after 300 mg CP), respectively. Based on literature evidence the blood levels obtained with the 300 mg CP suppositories would be therapeutic in the management of malaria and rheumatoid disease.
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PMID:Chloroquine absorption in children from polyethylene glycol base suppositories. 320 29

1. Chloroquine diphosphate (15 mg base kg-1) was given by constant rate intravenous infusion to two groups of Thai subjects. Eleven were patients with malaria (10 with Plasmodium vivax and one case with Plasmodium malariae) and 10 were healthy normal volunteers. 2. Plasma and packed red-cell concentrations of chloroquine, electrocardiographic intervals, arterial blood pressure and pulse were measured at frequent intervals. 3. Peak plasma concentrations at the end of the infusion ranged from 979 to 2,900 ng ml-1 in the malaria patients. In the group of healthy subjects the range was 550-2,200 ng ml-1. Values for terminal elimination rate constant, (lambda z) plasma clearance (CL), initial volume of distribution (V1) and volume of distribution at steady state (Vss) were calculated. For the healthy subjects, mean estimates of these parameters were lambda z = 0.062 +/- 0.030 day-1, CL = 597 +/- 238 ml min-1, V1 = 0.66 +/- 0.71 l kg-1 and Vss = 132 +/- 50 l.kg-1 For the group of malaria patients, the corresponding values were lambda z = 0.055 +/- 0.032 day-1, CL = 535 +/- 246 ml min-1, V1 = 0.74 +/- 0.75 l kg-1 and Vss = 136 +/- 64 l kg-1 There was no statistically significant difference in the estimates for any parameter between groups (P less than or equal to 0.05). 4. Chloroquine concentrations in packed red blood cells consistently exceeded those in plasma and showed no consistent change with time throughout the period of study in either group. The median value for the red cell to plasma ratio was between 3 and 4 in each group.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Pharmacokinetics of chloroquine in Thais: plasma and red-cell concentrations following an intravenous infusion to healthy subjects and patients with Plasmodium vivax malaria. 328 1

Out of 80 Danish college students and their teachers visiting the Middle East, West Pakistan, and India by bus in two four-month journeys during the summer and autumn of 1971, six individuals developed an apparently first attack of vivax malaria within seven to nine months after their return to Denmark. No cases of malaria were seen in the group during the journeys. Prophylaxis with chloroquine (Resochin) was strictly observed when visiting the areas in which malaria is endemic.All cases responded rapidly and completely to a full course of treatment with chloroquine. The most probable cause of the delay of the clinical manifestations is drug prophylaxis, which can prevent a clinical attack but not always eradicate the parasite.
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PMID:Delayed attacks of malaria in visitors to the tropics. 458 23

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

A clinical trial of malaria prophylaxis using a single dose of chloroquine at different intervals was carried out to determine if chloroquine could be given at intervals longer than advocated. The usual adult prophylactic dose of chloroquine recommended was 300 mg base once a week or 600 mg base once in 2 weeks, the dose being proportionately less for children. In conducting this study, a regrouped village consisting of 5 small villages in Chief Chikuwe's area (Zambia) was selected. The closest rural health center was situated 9 kilometers away from this village so the villagers did not have easy access to chloroquine tablets. The total population of the regrouped village with the exception of the primary school children (who received regular chloroquine prophylaxis at their schools once a month) were placed in 4 groups--A, B, C, and D using the random number tables. The groupings were found to be fairly well distributed in terms of age and sex. Each group had about 55-59 participants. On the 1st visit, blood samples were collected from everybody and thick and thin films were made from each individual's sample. All members of groups B, C, and D were given chloroquine, corresponding to his/her age. Chloroquine phosphate was used and the dose administered was as follows: 15 years and older, 600 mg base; 10-14 years, 300 mg base; 5-9 years, 150 mg base; and 0-4 years, 75 mg base. Individuals belonging to group A were given a placebo. The 2nd visit was made 1 month after the 1st visit and at this visit chloroquine was given to group B only. All the other groups received the placebo. On the 3rd visit, 2 months after the 1st visit, groups B and C received the chloroquine and groups A and D received the placebo. During the 4th visit, 3 months after the 1st visit, groups B and D received the chloroquine and groups A and C received the placebo. Out ofa total of 230 participants examined, 47 were found to be positive for malaria parasites giving a parasite rate of 20.43%. This parasite rate was found to be evenly distributed among the 4 study groups. The age group 12 months-14 years had the highest prevalence, the parasite rate being 32.26%. In group A, the control group, there was hardly any change in parasite rate. In group B, who received the prophylactic once a month, the parasite rate fell from 22.03% to zero at the end of 3 months. In group C, who received the prophylactic once in 2 months, the parasite rate fell from 18.97% to 1.79% at the end of the study period. In group D, who received the prophylactic once in 3 months, the parasite rate fell from 24.14% to 8.77% at the end of 3 months.
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PMID:A clinical trial of malaria prophylaxis using a single dose of chloroquine at different intervals in an endemic malarious area. 700 Oct 39

A total of 1059 persons from 14 different locations in Ibadan (the most populous city in tropical Africa) were interviewed to determine whether they had had itch reaction with each of the 12 4-aminoquinoline preparations (one amodiaquine hydrochloride, 11 chloroquine). The various trade and pharmacological names are listed in a table. Respondents were asked for what purpose the listed drugs were used: treatment of an attack of malaria fever; prevention of malaria; and other conditions or illnesses. The respondents were also asked how often each subject had an attack of malaria: monthly, every 3 months, every 6 months, once a year, once every 2-3 years, less often than this, never. Inquiry was made regarding details of the itch reaction since there was particular interest in the pruritus which, judging from previous studies, constitutes the 1 reaction most likely to make 4-aminoquinolines unpopular. Chloroquine sulphate tablets, the 8th most popular preparation, was the 6th on the list of itching incidence. There appeared to be no difference in the incidence of itching after chloroquine sulphate injection. Avloclor tablets, chloroquine phosphate injection tablets and Malarex and Aralen tablets gave a comparatively low incidence of itch reaction--3.4% and 1.4% respectively within the population studied. The incidence of itching after these 4-aminoquinoline preparations may also be estimated in the population sampled by finding the mean percentage of the subjects who itch within those who admitted taking each preparation mentioned in the questionnaire. The corrected percentage incidence gave an estimated mean of 28% compared with a mean incidence of 11% when projected to the whole population sampled. Most of the people (90%) used the 4-aminoquinoline antimalarials to treat an attack of malaria fever; 23% take them for prophylaxis and 7% in the population used the drugs for nonmalarial ailments. The misuse of the drugs for nonmalarial ailments may be related to their potency in treating malaria. In sum, the itch reaction failed to conform to a simple clinical pattern.
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PMID:Use and misuse of 4-aminoquinoline antimalarials in tropical Africa and re-examination of itch reaction to these drugs. 726 16

Malaria has had an enormous impact on human history, not least in times of war. The disease has been treatable by a natural remedy, quinine, since the 17th century, but the production of synthetic antimalarial agents was first achieved in Germany in the wake of the Great War of 1914-1918, in which malaria had caused immense problems. In the 1920s research workers in the Bayer laboratories of the IG Farbenindustrie consortium developed the 8-aminoquinoline plasmoquine (the forerunner of primaquine). They went on to develop the acridine dye, atebrin (mepacrine) and the 4-aminoquinolines, Resochin (developed at the end of the Second World War in America as chloroquine) and Sontochin. British attempts to match the advances achieved by the Germans were at first unproductive, partly because collaboration between academic and industrial organizations in the UK was beset by concerns over patent rights. However, with the outbreak of World War II, when supplies of antimalarials were scarce, ICI succeeded in the large-scale production of mepacrine (essential to prosecution of the war, particularly in the Far East) and also initiated a programme of collaborative research that eventually led to the discovery of proguanil (Paludrine); this, in its turn led to the diaminopyrimidine, pyrimethamine. A massive cooperative screening programme in the USA during World War II eventually bore fruit in the realization of the therapeutic potential of chloroquine, and in the later development of amodiaquine and primaquine. Some of this work also influenced the subsequent discovery of mefloquine and halofantrine at the Walter Reed Army Institute of Research.
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PMID:Conflicts of interest: the genesis of synthetic antimalarial agents in peace and war. 862 69


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