Some aspects of treatment, prophylaxis and chemoresistance of plasmodium falciparum malaria

Antimalarial drug susceptibility testing of Plasmodium falciparum in Brazil using a radioisotope method

“…In order to avoid such a impairment, resistance monitoring is of uppermost importance, at best by in vivo and in vitro methods. The present study confirmed the high level of resistance to chloroquine previously demonstrated in other areas of the Amazon basin (Boulos et al 1986, Alecrim 1986, Di Santi et al 1988, Zalis et al 1998. Regarding quinine, besides the low true-resistance percentage observed (3.3%), IC 50s to the tested samples were as high as those observed in other areas of the world with decreased susceptibility (Webster et al 1985), suggesting that the usefulness of the drug will not last for a long time.…”

“…Migrant populations disseminate resistant strains throughout the region and lead them to malaria free areas, increasing the risks of outbreaks (Marques 1986). Plasmodium falciparum drug resistance in Brazil has developed at an alarming rate to chloroquine, Fansidar® and to some extent quinine (Boulos et al 1986). As vector control is not a realistic approach in this region, early diagnosis and effective treatment are essential tools for control strategies.…”

“…Malaria prevalence in Brazil has increased three times during the past and quinine in those studies were too low, leading to overestimation of the resistance percentages (Alecrim 1986, Di Santi et al 1988) When adequate "cut off" limits are employed, taking together in vivo and in vitro data, parasite resistance has been observed at levels greater than 70% to chloroquine, greater than 60% to sulfadoxine-pyrimethamine, lower than 20% to quinine and almost none to mefloquine (Boulos et al 1986, Alecrim 1986, Di Santi et al 1988, Kremsner et al 1989, Souza 1992, Couto et al 1993. As in vitro evaluations of P. falciparum sensitivity have not been performed since the 80's (Di Santi et al 1988, Kremsner et al 1989, and considering that radioisotopic methods had not been used, except in one occasion (Zalis et al 1998), we decided to verify the patterns of resistance in a typical endemic area of the Brazilian Amazon region.…”

Avaliação clínica do quinino para o tratamento de malária por Plasmodium falciparum

“…Aparentemente, a pior resposta encontrada com a associação de quinino com sulfadoxina e pirimetamina, quando comparada ao quinino, se deve ao fato de se utilizar quinino por apenas 3 dias nessa associação e corrobora com a conhecida resistência disseminada do P. falciparum à associação sulfadoxina-pirimetamina 3 .…”

Hemoglobinas humanas: hipótese malária ou efeito materno?

“…Por vezes o quadro da malária cerebral lembra o da meningite ou do téta-no, da epilepsia, do alcoolismo dentre outras enfermidades neurológicas. 8 …”