Parasitemia

Publication Title: 
Tropical medicine & international health: TM & IH

Intramuscular artemether given for five days was evaluated prospectively in 32 patients with acute recrudescent Plasmodium falciparum malaria. All patients had experienced one or more treatment failures with one or more courses of the following drugs: chloroquine, amodiaquine, sulphadoxine-pyrimethamine and erythromycin given alone or in combination. There was a prompt response to treatment with fever and parasite clearance times of 10.7 (3.6) h (range 6-24) and 32.3 (8.3) h (range 24-48) respectively. Parasite reduction at 24 h was 93.2 (7.8)% (range 75-100).

Author(s): 
Sowunmi, A.
Odulola, A. M.
Publication Title: 
The American Journal of Tropical Medicine and Hygiene

A randomized pilot study to compare the safety and efficacy of artesunate suppositories (15 mg/kg/day for three days) versus oral artesunate (6 mg/kg/day for three days), both in combination with mefloquine (25 mg/kg), was conducted in 52 Thai children with uncomplicated multidrug-resistant falciparum malaria. Forty-five patients (87%) had a full 28-day follow-up in the hospital to assess efficacy and exclude reinfection. Mean [range] times to fever clearance of the two groups were similar (42 hr [15-104] versus 42 hr [6-119]).

Author(s): 
Sabchareon, A.
Attanath, P.
Chanthavanich, P.
Phanuaksook, P.
Prarinyanupharb, V.
Poonpanich, Y.
Mookmanee, D.
Teja-Isavadharm, P.
Heppner, D. G.
Brewer, T. G.
Chongsuphajaisiddhi, T.
Publication Title: 
Tropical medicine & international health: TM & IH

OBJECTIVES: To compare artemether (by intramuscular injection) and quinine (by intravenous infusion) as treatments for cerebral malaria in African children. METHODS: An open, randomized trial conducted at the Queen Elizabeth Central Hospital in Blantyre, Malawi. This trial was part of a multicentre study designed to determine if treatment with artemether would significantly lower mortality rates compared with quinine. Data from 83 artemether recipients and 81 quinine recipients are reported here.

Author(s): 
Taylor, T. E.
Wills, B. A.
Courval, J. M.
Molyneux, M. E.
Publication Title: 
The American Journal of Tropical Medicine and Hygiene

The effect of pentoxifylline (PTX) was tested for its capacity to modulate cytokine responses during therapy of severe Plasmodium falciparum malaria in a placebo-controlled, randomized study in 45 adult patients in Bangkok, Thailand. The patients received standard antimalarial treatment with artesunate (120 mg intravenously given immediately, then 60 mg every 12 hr for a total dose of 600 mg). The patients received either low-dose PTX (20 mg/kg/day, n = 15), high-dose PTX (40 mg/kg/day, n = 15), or placebo (n = 15) as continuous infusion for the first three days of antimalarial treatment.

Author(s): 
Wenisch, C.
Looareesuwan, S.
Wilairatana, P.
Parschalk, B.
Vannapann, S.
Wanaratana, V.
Wernsdorfer, W.
Graninger, W.
Publication Title: 
The American Journal of Tropical Medicine and Hygiene

A thermostable suppository of artesunate (artesunic acid) has been developed. In Gabon, 12 children with Plasmodium falciparum malaria received two administrations of this suppository in a 4-hr interval. Parasitemia and fever were then measured and the plasma levels of artesunate and its active metabolite, dihydroartemisinin, were determined by means of a reversed phase high-pressure liquid chromatography method using reductive electrochemical detection.

Author(s): 
Halpaap, B.
Ndjave, M.
Paris, M.
Benakis, A.
Kremsner, P. G.
Publication Title: 
Proceedings of the National Academy of Sciences of the United States of America

Clinical investigation of malaria is hampered by the lack of a method for estimating the number of parasites that are sequestered in the tissues, for it is these parasites that are thought to be crucial to the pathogenesis of life-threatening complications such as cerebral malaria. We present a method of estimating this hidden population by using clinical observations of peripheral parasitemia combined with an age-structured mathematical model of the parasite erythrocyte cycle.

Author(s): 
Gravenor, M. B.
van Hensbroek, M. B.
Kwiatkowski, D.
Publication Title: 
The American Journal of Tropical Medicine and Hygiene

To investigate the pharmacokinetic and pharmacodynamic properties of artesunate (ARTS) and its active metabolite dihydroartemisinin (DHA) in Plasmodium vivax infections, 12 male Vietnamese adults with slide-positive vivax malaria received either intravenous ARTS (120 mg; group 1) or oral ARTS (100 mg; group 2) with the alternative preparation given 8 hr later in a randomized, open, cross-over study.

Author(s): 
Batty, K. T.
Le, A. T.
Ilett, K. F.
Nguyen, P. T.
Powell, S. M.
Nguyen, C. H.
Truong, X. M.
Vuong, V. C.
Huynh, V. T.
Tran, Q. B.
Nguyen, V. M.
Davis, T. M.
Publication Title: 
The American Journal of Tropical Medicine and Hygiene

The factors affecting the development of patent Plasmodium falciparum gametocytemia were assessed in 5,682 patients entered prospectively into a series of antimalarial drug trials conducted in an area of low and seasonal transmission on the western border of Thailand. Of the 4,565 patients with admission thick smear assessments, 110 (2.4%) had gametocytemia. During the follow-up period 170 (3%) of all patients developed patent gametocytemia, which in 89% had developed by day 14 following treatment.

Author(s): 
Price, R.
Nosten, F.
Simpson, J. A.
Luxemburger, C.
Phaipun, L.
ter Kuile, F.
van Vugt, M.
Chongsuphajaisiddhi, T.
White, N. J.
Publication Title: 
The American Journal of Tropical Medicine and Hygiene

Single doses (250, 500, 1,000, or 2,000 units/kg) of an ovine polyclonal-specific Fab fragment directed against tumor necrosis factor-alpha (TNF-alpha) were given to 17 adult patients with severe falciparum malaria immediately before treatment with artesunate in a pilot study to assess safety and optimal dosage with a view to future studies. Clinical and laboratory variables were compared with 11 controls. In the groups given Fab, there was a tendency for a faster resolution of clinical manifestations and reduction of fever but also a tendency towards longer parasite clearance times.

Author(s): 
Looareesuwan, S.
Sjostrom, L.
Krudsood, S.
Wilairatana, P.
Porter, R. S.
Hills, F.
Warrell, D. A.
Publication Title: 
The American Journal of Tropical Medicine and Hygiene

To define the current efficacy of Fansidar (F. Hoffmann-La Roche Ltd., Basel Switzerland) (pyrimethamine and sulfadoxine), primaquine in a high dose, and artesunate for treating acute Plasmodium vivax malaria, we conducted a comparative clinical trial of these 3 drugs in an open-label study. Patients (15-65 years old) were assigned to 1 of 4 treatments regimens in a serial order. Ninety percent of the patients were infected at Thailand-Myanmar border.

Author(s): 
Wilairatana, P.
Silachamroon, U.
Krudsood, S.
Singhasivanon, P.
Treeprasertsuk, S.
Bussaratid, V.
Phumratanaprapin, W.
Srivilirit, S.
Looareesuwan, S.

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