RESUMO
Introduction: Malaria is a major health threat in India. Many states including Guj and focal outbreaks of malaria from 1997 to 2006. A defence establishment located in western part of India suffered from an epidemic of BT malaria in 2005, which was confirmed by epidemiological investigation. Material and methods: An outbreak of malaria occurred in a closed defence campus was investigated by an epidemiologist and was confirmed as an epidemic. Measures advised for its co and further prevention were strictly implemented to control it. The study is based on the reported information and data collected at the time of investigation. Results: In a population of 4832 in a closed campus, 363 cases were reported with high slide positivity rate of 27.07 percent and overall API of 75.12 per thousand populations. The incidence was relatively higher among the children below 16 years with a very high API of 156.43 in 6-11 years' age group. High spleen rate and infant parasite rate confirmed the local transmission of malaria. An excessive breeding of vector was noticed as several places. Discussion: The campus suffered from BT malaria epidemic with very high API among younger population of school going children mainly due to local transmission caused by An. stephensi. Vactoe was found breeding heavily in pools, ditches, overhead tanks and static tanks. The epidemic resulted due to insincere efforts in implementing anti-malaria activities. Conclusion: The epidemic affected all age groups with a very high incidence in pre-school and school going children especially 6-11 years' age group. Lack of anti-malaria activities, uncontrolled breeding of anopheles in the campus, delay in diagnosis and treatment, poor reporting, record maintenance and follow up of the cases were the causes of the epidemic. It was effectively controlled by implementing measures of control suggested by the epidemiologist.
RESUMO
Introducción: se ha evaluado poco en el mundo la eficacia del tratamiento con cloroquinaprimaquina para el ataque agudo y, sobre todo, para las recurrencias del paludismo vivax en niños; esos estudios en América Latina son muy escasos y casi inexistentes en Colombia.Objetivo: evaluar la eficacia de dos dosificaciones de primaquina en menores de 18 años.Materiales y métodos: estudio clínico controlado, no enmascarado, con asignación aleatoria del tratamiento. Se evaluaron dos grupos según la dosis de primaquina: 0,50 mg/kg/día por 7 días (0,50-7) frente a 1,17 mg/kg/día por 3 días (1,17-3).Resultados: A. Curación del ataque agudo: eficacia del 100% en los dos grupos; B. Prevención de las recurrencias durante 120 días: ocurrieron recurrencias en 68,4% de los niños tratados con el esquema 1,17-3, y en 34,2% de los que recibieron el régimen 0,50-7.Conclusiones: 1. La proporción de recurrencias a los 120 días en niños tratados con el esquema 0,50-7 (34,2%) fue significativamente menor que la de los niños que recibieron el régimen 1,17-3 (68,4%). 2. El tiempo de administración de una misma dosis total de primaquina influye en su eficacia contra las recurrencias: a menos días, menor eficacia.
Introduction: Worldwide, the efficacy of cloroquine-primaquine for treating acute Plasmodiumvivax malarious attacks has not been thoroughly evaluated. In Latin America such studies arescarce, and in Colombia, almost nonexisting. Objective: To assess the efficacy of two regimens foradministration of primaquine in children aged less than18 years. Methodology: A clinical, controlled, unmasked studywas carried out, with randomized administration of twoprimaquine regimens, namely: 0.50 mg/kg/day for 7days (0.50-7) vs. 1.17 mg/kg/day for 3 days (1.17-3). Results: A. Healing of the acute attack: efficacy was100% in both groups. B. Prevention of recurrencesduring 120 days: recurrences occurred in 68.4% ofchildren treated with the 1.17-3 regimen, and in 34.2%of those receiving the 0.5-7 one. Conclusions: 1. Proportion of recurrences during the120 days follow-up was significantly lower (34.2%) inchildren receiving the 0.50-7 regimen than in thosetreated with the 1.17-3 one (68.4%). The length ofadministration of the same total dose of primaquineinfluenced its efficacy against recurrences: shorterperiods of administration were associated with lesserefficacy.