Subject(s)
Brain Abscess/surgery , Malaria , Plasmodium malariae , Postoperative Complications , Tuberculoma, Intracranial/surgery , Animals , Humans , Malaria/drug therapy , Male , Middle Aged , Parietal Lobe/surgery , Plasmodium malariae/isolation & purification , Postoperative Complications/drug therapy , RecurrenceABSTRACT
Two cases of cerebral malaria imported from Guyana and Ghana are reported. These are the first cases of cerebral malaria diagnosed and treated in Trinidad and Tobago since malaria was eradicated. The management of both these cases was complicated because the patients' erythrocytes were glucose-6-phosphate dehydrogenase-deficient, and by the occurrence of blackwater fever, cerebral manifestations, renal impairment, hyperglycaemia and thrombocytopenia. The symptoms of cerebral malaria resolved following treatment with quinidine and doxycycline and quinidine and clindamycin.
Subject(s)
Glucosephosphate Dehydrogenase Deficiency/complications , Malaria, Cerebral/complications , Travel , Adult , Antimalarials/therapeutic use , Ghana , Guyana , Humans , Malaria, Cerebral/blood , Malaria, Cerebral/drug therapy , Male , Middle Aged , Trinidad and TobagoABSTRACT
The first case of psychosis due to Plasmodium vivax malaria, imported from India is reported. A 44-year-old Trinidadian male presented with fever, and psychotic episodes in association with vivax malaria. The symptoms of both malaria and psychosis were resolved following the standard chloroquine-primaquine therapy.
Subject(s)
Malaria, Cerebral/complications , Malaria, Vivax/complications , Neurocognitive Disorders/parasitology , Adult , Antimalarials/therapeutic use , Chloroquine/therapeutic use , Humans , Malaria, Vivax/drug therapy , Male , Primaquine/therapeutic useABSTRACT
Two cases of cerebral malaria imported from Guyana and Ghana are reported. These are the first cases of cerebral malaria diagnosed and treated in Trinidad and Tobago since malaria was eradicated. The management of both these cases was complicated because the patients' erythrocytes were glucose-6-phosphate dehydrogenase-deficient, and by the occurrence of blackwater fever, cerebral manifestations, renal impairment, hyperglycaemia and thrombocytopenia. The symptoms of cerebral malaria resolved following treatment with quinidine and doxycycline and quinidine and clindamycin (AU)
Subject(s)
Adult , Humans , Malaria, Cerebral/drug therapy , Trinidad and Tobago , Glycogen Storage Disease Type I/diagnosis , Blackwater Fever/complications , Caribbean Region , Quinidine , Developing CountriesABSTRACT
The first case of psychosis due to Plasmodium vivax malaria, imported from India is reported. A 44-year-old Trinidadian male presented with fever, and psychotic episodes in association with vivax malaria. The symptoms of both malaria and psychosis were resolved following the standard chloroquine-primaquine therapy (AU)
Subject(s)
Adult , Humans , Psychotic Disorders/diagnosis , Trinidad and Tobago , Case Management , Trinidad and Tobago , Malaria, Vivax/complications , Caribbean RegionABSTRACT
A microfilaria survey was conducted in Trinidad in 1992, 12 years after mass treatment with spaced doses of diethylcarbamazine citrate (DEC-C) for the control of Bancroftian filariasis; 348 persons were examined using thick blood smears and a membrane filtration technique. They included 104 who had participated in the mass chemotherapy campaign in 1980. No Wuchereria bancrofti microfilariae were detected among 66% of the population examined. In 1980, 86 of 592 persons examined were found to be infected with W. bancrofti, 140 with Mansonella ozzardi and 44 with mixed infections, while in 1992, only M. ozzardi infections persisted despite treatment with DEC-C. Of the 104 persons reexamined 12 years later, 46 had M. ozzardi, of which five were new cases, but none had W. bancrofti. During both the 1980 and 1992 surveys, low microfilariae rates for M. ozzardi were observed among those 19 years of age or younger. Of the 302 persons newly examined in 1992, 29 were infected with significantly (P < 0.001) more males (79.3%) than females (20.9%) being microfilaremic. The combined results showed similar prevalence rates for M. ozzardi from 23.3% to 21.6% in 1980 and 1992. Nuclepore membrane filtration and thick blood films were very efficient in demonstrating the presence of microfilariae. The usefulness of these methods and spaced treatment using DEC-C are also discussed.
Subject(s)
Diethylcarbamazine/therapeutic use , Filariasis/prevention & control , Mansonella , Mansonelliasis/prevention & control , Wuchereria bancrofti , Adolescent , Adult , Age Distribution , Animals , Child , Child, Preschool , Female , Filariasis/epidemiology , Follow-Up Studies , Humans , Infant , Male , Mansonelliasis/epidemiology , Microfilariae/isolation & purification , Middle Aged , Parasitemia/epidemiology , Prevalence , Sex Distribution , Trinidad and Tobago/epidemiologyABSTRACT
A microfilaria survey was conducted in Trinidad in 1992, 12 years after mass treatment with spaced doses of diethylcarbamazine citrate (DEC-C) for the control of Bancroftian filariasis; 348 persons were examined using thick blood smears and a membrane filtration technique. They included 104 who had participated in the mass chemotherapy campaign in 1980. No Wuchereria bancrofti microfilariae were detected among 66 percent of the population examined. In 1980, 86 of 592 persons examined were found to be infected with W. bancrofti, 140 with Mansonella ozzardi and 44 with mixed infections, while in 1992, only M. ozzardi infections persisted despite treatment with DEC-C. Of the 104 persons re-examined 12 years later, 46 had M. ozzardi, of which five were new cases, but none had W. bancrofti. During both the 1980 and 1992 surveys, low microfilariae rates for M. ozzardi were observed among those 19 years of age or younger. Of the 302 persons newly examined in 1992, 29 were infected with significantly (P<0.001) more males (79.3 percent) than females (20.9 percent) being microfilaremic. The combined results showed similiar prevalence rates for M. ozzardi from 23.3 percent to 21.6 percent in 1980 and 1992. Nucleopore membrane filtration and thick blood films were very efficient in demonstrating the presence of microfilariae. The usefulness of these methods and spaced treatment using DEC-C are also discussed (AU)
Subject(s)
Humans , Anthelmintics/analysis , Trinidad and Tobago , Elephantiasis, Filarial/parasitology , Trinidad and Tobago , Insect Vectors , Trinidad and Tobago , Culex , Caribbean Region , Treatment Outcome , Trinidad and Tobago , Wuchereria bancrofti/drug effects , Trinidad and TobagoABSTRACT
A new mode of administering malaria chemotherapy to patients unable to tolerate oral medication is described. A patient with Plasmodium falciparum malaria, severe hyponatremia and hypokalaemia who regurgitated oral treatment of chloroquine phosphate and pyrimethamine and sulfadoxine (Fansidar) is presented. But neither chloroquine nor quinine intravenous formulations were available locally. As the patient was deteriorating, a suspension of chloroquine phosphate was prepared and administered rectally, resulting in a decline in the level of parasitaemia from ++++ to ++ within 48 hours. The patient improved, and further clinical management was uncomplicated.
Subject(s)
Chloroquine/administration & dosage , Developing Countries , Malaria, Falciparum/drug therapy , Administration, Rectal , Adult , Chloroquine/adverse effects , Humans , Male , Suspensions , Trinidad and TobagoABSTRACT
A new mode of administering malaria chemotherapy to patients unable to tolerate oral medication is described. A patient with Plasmodium falciparum malaria, severe hyponatraemia and hypokalaemia who regurgitated oral treatment of chloroquine phosphate and pyrimethamine and sulfadoxine (Fansidar) is presented. But neither chloroquine nor quinine intravenous formulations were available locally. As the patient was deteriorating, a suspension of chloroquine phosphate was prepared and administered rectally, resulting in a decline in the level of parasitaemia from ++++ to ++ within 48 hours. The patient improved, and further clinical management was uncomplicated.
Subject(s)
Humans , Adult , Male , Malaria/drug therapy , Administration, Rectal , Chloroquine/administration & dosageABSTRACT
A new mode of administering malaria chemotherapy to patients unable to tolerate oral medication is described. A patient with Plasmodium falciparum malaria, severe hyponatraemia and hypokalemia who regurgitated oral treatment of chloroquine phosphate and pyrimethamine and sulfadoxine (Fansidar) is presented. But neither chloroquine nor quinine intravenous formulations were available locally. As the patient was deteriorating, a suspension of chloroquine phosphate was prepared and administered rectally, resulting in a decline in the level of parasitaemia from ++++ to ++ within 48 hours. The patient improved, and further clinical management was uncomplicated (AU)
Subject(s)
Adult , Humans , CASE REPORT , Malaria, Falciparum/drug therapy , Trinidad and Tobago , Chloroquine/pharmacology , Administration, Rectal , Treatment Outcome , Caribbean Region , Hypokalemia/epidemiologyABSTRACT
An outbreak of Plasmodium vivax malaria occurred in Trinidad some 25 years after a successful eradication programme. The 'index case' was infected while visiting Perdaneles, Venezuela, and was responsible for the renewal of malaria transmission by indigenous Anopheles aquasalis mosquitoes in Icacos, Trinidad, W.I. Nine cases (four females and five males) of P. vivax malaria were locally transmitted in Icacos. Most of the cases (70%) were in the 15-24 or 25-44 year age groups. In Granville/Chatham, another, unrelated case of locally transmitted P. vivax malaria was discovered through active surveillance. The intervention measures adopted, which successfully eradicated P. vivax malaria from Trinidad, are described. The need to maintain malaria surveillance is emphasized.
