Résumé
Ten patients with uncomplicated malaria, ten with cerebral malaria and 37 controls (blood donors from blood bank) were included in the study. The serum cortisol levels of the patients were determined daily for 7 days while they were at the hospital. A radio-immunoassay method was used for quantitative measurement of cortisol in human serum. The mean serum cortisol level of patients with uncomplicated malaria was 528.2 +/- 123.9 nmol/l, with cerebral malaria was 516.0 +/- 80.5 nmol/l, and in controls was 393.8 +/- 141.0 nmol/l. There was a significant rise of serum cortisol levels in patients with malaria when compared to controls at the day of admission to hospital. There was no significant difference between uncomplicated malaria patients and those with cerebral malaria. There was also no significant difference between the different days of treatment up till day 7. We found no cortisol insufficiency in cases with falciparum malaria during acute and convalescent stages of illness.
Sujets)
Adolescent , Adulte , Femelle , Humains , Hydrocortisone/sang , Paludisme cérébral/sang , Mâle , Adulte d'âge moyen , Dosage radioimmunologiqueRésumé
The effect of artemether plus mefloquine versus quinine on 35 patients with complicated falciparum malaria including 5 patients with cerebral malaria were studied. All patients treated with the artemether-mefloquine combination survived and all were free from toxic effects of the drugs. Three patients on quinine therapy died. The mortality rate was 8.5%. The mean parasite clearance time of patients treated with artemether plus mefloquine was significantly shorter than those treated with quinine but there was no significant difference in the mean fever clearance of the two groups of patients. There was no recrudescence with artemether and mefloquine; the recrudescence rate was 5.5% with quinine. The study showed that the artemether-mefloquine combination is superior to quinine for the treatment of patients with complicated falciparum malaria, including cerebral malaria.