ABSTRACT
This study is an initial attempt to apply disease mapping through Geographical Information System (GIS) with multiple regression analysis to determine the nature and extent of factors influencing malaria transmission in Yunnan Province, PR China, particularly in border areas. Secondary county-based data covering the period 1990 to 1996 were collected and analyzed. The malaria situation in Yunnan Province as a whole is influenced mainly by the combined effects of the physical environment, the presence of efficient vector species, and mobile population along international borders with Myanmar, Lao PDR and Vietnam.
Subject(s)
China/epidemiology , Demography , Humans , Information Management/organization & administration , Malaria, Falciparum/epidemiology , Population Surveillance/methods , Regional Health Planning/organization & administrationABSTRACT
Important questions related to the factors responsible for and contributing to the origin and spread of multi-drug resistant falciparum malaria at the Thai-Cambodian and Thai-Myanmar border areas are discussed, including the current geographical distribution of multi-drug resistance and the prevention and control of this phenomenon. Specific recommendations are made on epidemiological surveillance, drug deployment, vector control, and the problem of migration which plays a major role in the dissemination of resistant parasite populations. The recent advent of mefloquine resistance of P. falciparum in Thailand may serve as fair warning in the absence of stern measures for preventing the occurrence of resistance to the next and currently last line of antimalaria drugs, especially those with a long half-life, in areas with intensive, uncontrolled malaria transmission, such as tropical Africa.
Subject(s)
Aftercare , Antimalarials/pharmacokinetics , Cambodia/epidemiology , Clinical Protocols , Drug Monitoring , Drug Resistance , Emigration and Immigration , Health Policy , Humans , Malaria, Falciparum/drug therapy , Mefloquine , Mosquito Control , Myanmar/epidemiology , Population Surveillance/methods , Residence Characteristics , Thailand/epidemiologyABSTRACT
In an open clinical trial, thirty patients 14 to 44 years old and with acute uncomplicated falciparum malaria were given halofantrine hydrochloride 500 mg (2 tablets) 6-hourly for 3 doses, a total dose of 1500 mg. All 30 patients were cured, with a mean asexual parasite clearance time of 47.6 hours and mean fever clearance time of 36.6 hours. Post-dosing side-effects occurred in 6 patients consisting of mild to moderate headache, dizziness and abdominal muscle spasm. Drug-induced hemolysis did not occur in two G6PD deficient patients. Twenty-three out of 28 isolates tested (82%) were resistant to amodiaquine, 3 (11%) were resistant to the sulfadoxine-pyrimethamine combination, and all were sensitive to chloroquine, quinine and mefloquine by in vitro microtests. The study confirms the efficacy of halofantrine hydrochloride as a blood schizonticide in falciparum malaria.
Subject(s)
Acute Disease , Administration, Oral , Adolescent , Adult , Blood Cell Count , Blood Chemical Analysis , Drug Resistance , Hematocrit , Hemoglobins/analysis , Humans , Malaria, Falciparum/blood , Parasite Egg Count , Phenanthrenes/administration & dosageABSTRACT
Clinical trials on oral clindamycin as an antimalarial in hospitalized patients and residents of endemic communities were conducted in the Philippines between May 1984 and December 1985. Seven and 9 qualified subjects in hospital were treated with 300 mg (regimen A) and 600 mg (regimen B) respectively, twice daily for 5 days. Eighteen patients seen at a rural health unit were given the lower dosage. On the basis of the 28-day extended in vivo test of WHO, P. falciparum in all but one patient showed susceptibility to the drug as a blood schizontocide hence, the clinical cure of malaria. Side effects were few and self-limiting. Ten other patients on regimen A were cured within the 7- and/or 28-day extended test period. Clindamycin per se is currently one of the few alternatives in the treatment of clinically moderate drug-resistant malaria.
Subject(s)
Acute Disease , Administration, Oral , Adolescent , Adult , Animals , Child , Clindamycin/therapeutic use , Female , Humans , Malaria/diagnosis , Male , Middle Aged , Parasite Egg Count , Plasmodium falciparum , Prospective StudiesSubject(s)
Animals , Anopheles/classification , Humans , Insect Vectors/classification , Malaria/epidemiology , PhilippinesABSTRACT
The occurrence of biting midge infestation involving the species Leptoconops (Styloconops) spinosifrons Carter 1921 (Diptera, Ceratopogonidae) is reported from a beach resort in Mindoro Island, Philippines. The flies are most active between 0700 and 0900 hours, and again, between 1600 and 1800 hours; they are most abundant in the shoreline and sand beach area.