Quinine therapy in severe Plasmodium falciparum malaria during pregnancy in Sudan

A prospective study was carried out in an area of unstable malaria transmission in central Sudan to determine the efficacy and toxicity of quinine in pregnancy. Thirty-three pregnant women with severe Plasmodium falciparum malaria at mean 28.8 weeks gestational age were treated with quinine for 7 days. The mean body temperature on presentation for 3 patients who delivered prematurely was significantly higher than for those who delivered at term [39.2 +/- 0.7 degrees C versus 38.7 +/- 1.3 degrees C]. There were no significant difference between the 2 groups in other clinical or biochemical parameters. There were no clinically detectable congenital malformations and no auditory, visual or other neurological deficits in the babies at birth or 6 months later. Quinine may be safe in the treatment of severe falciparum malaria during pregnancy

Approaches to the control and elimination of the clinically important filarial diseases

Mass drug administration programs are the mainstay of current attempts to control and rid the globe of the two major filarial diseases of humans, onchocerciasis and lymphatic filariasis. There are a number of important components to developing and maintaining a treatment program; these include advocacy, communication, financial support, and the presence of local "champions" to lead the program. Two active country programs -lymphatic filariasis elimination in Tanzania and onchocerciasis control in Sudan -provide practical examples of these program needs. There are a number of positive consequences of a successful program that extend outside the primary goal of disease control or elimination; these include national infrastructure and personnel development. The challenges and consequent actions that could be taken to ensure the success of control programs are discussed