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[Malaria prevention today and tomorrow].

H Félix1, M Danis

  • 1Département de Parasitologie et des Maladies Tropicales, C.H.U. Pitié-Salpêtrière, Paris.

Bulletin De La Societe De Pathologie Exotique Et De Ses Filiales
|January 1, 1987
PubMed
Summary

Individual chemoprophylaxis against malaria is essential for travelers to endemic areas. Updated guidelines detail drug choices, dosages, and treatment strategies to combat Plasmodium falciparum resistance and manage malaria attacks effectively.

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Area of Science:

  • Tropical Medicine
  • Infectious Diseases
  • Pharmacology

Context:

  • Malaria chemoprophylaxis is mandatory for travelers to endemic regions.
  • Current antimalarial drugs include amino-4-quinolines, quinine, antifolinics, and mefloquine.
  • Drug selection depends on Plasmodium resistance, trip duration, and local infection risk.

Purpose:

  • To provide comprehensive guidelines for malaria chemoprophylaxis and treatment.
  • To outline drug-specific advantages, side effects, and dosages for prophylaxis.
  • To address the evolving landscape of malaria treatment due to drug resistance.

Summary:

  • Amodiaquine use is restricted due to severe adverse reactions; sulfadoxine-pyrimethamine is not recommended for prophylaxis.
  • Chloroquine is prioritized in chloroquine-sensitive areas; mefloquine is reserved for short stays and resistant cases.
  • Mefloquine is crucial for treating multi-drug resistant Plasmodium falciparum infections.
  • Treatment of malaria attacks is emphasized, especially in chloroquine-resistant zones, using quinine, sulfadoxine-pyrimethamine, or mefloquine.
  • Continuous chemoprophylaxis is discouraged in holoendemic areas, shifting focus to prompt treatment of malaria crises.

Impact:

  • Updated chemotherapy regimens aim to control malaria spread and prevent further drug resistance.
  • These strategies are vital pending the development of effective anti-malaria immunoprophylaxis.
  • The guidelines support targeted prophylaxis for specific high-risk situations like pregnancy or surgery.

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