Impact of UK malaria prophylaxis policy on imported malaria

Behrens, RH; Bradley, D; Snow, Robert W.; Marsh, Kevin

doi:10.1016/s0140-6736(05)64523-0

Cited by 5 publications

(1 citation statement)

References 3 publications

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“…Approximately 2000 people return with malaria parasites to the UK each year and less than half of these have vivax malaria that can be transmitted by An. atroparvus (Behrens et al, 1996). Since 9•8 million people travel to malarious countries each year, on average a person with malaria parasites will come to the Isle of Sheppey every 20 years.…”

Section: Discussionmentioning

confidence: 99%

Perceived Nuisance of Mosquitoes on the Isle of Sheppey, Kent, Uk

Hutchinson

Lindsay

2005

J. Biosoc. Sci.

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Little is known about the biting nuisance of mosquitoes in the UK, despite the high numbers found in some locations. A telephone questionnaire survey was used to determine the perceived nuisance of biting insects on the Isle of Sheppey, Kent, a place notorious for mosquitoes. Two hundred randomly selected individuals were interviewed and asked if they suffered from mosquito bites. If they answered yes, they were asked to describe where and when they were bitten, and what measures they took against mosquitoes. Forty-six percent of respondents completed the questionnaire. Of those, 50% reported being bitten by mosquitoes, mostly outside during the summer. Seventy percent said that most biting occurred during the evening and night. Of those respondents who protected themselves against biting (27), most used repellents (70%), with the remainder changing their behaviour to avoid mosquitoes, including closing or screening windows (33%), wearing thicker clothes (7%) and spraying insecticide (4%). One person slept under a bednet in summer (4%). This study provides evidence that on the Isle of Sheppey mosquitoes are considered a major nuisance by a sizeable proportion of the population. Since there is growing interest in the threat posed by new and emerging diseases in the UK, health authorities will need to make substantial efforts to inform and reassure the public about the threats posed by mosquitoes in areas where they are common.

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Section: Discussionmentioning

confidence: 99%

Perceived Nuisance of Mosquitoes on the Isle of Sheppey, Kent, Uk

Hutchinson

Lindsay

2005

J. Biosoc. Sci.

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Malaria prevention and stand-by emergency treatment among Japanese travelers

Kimura

Kawakami

Hashimoto³

et al. 2006

Travel Medicine and Infectious Disease

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Mefloquine for Malaria Chemoprophylaxis 1992–1998: A Review

Schlagenhauf

1999

J Travel Medicine

113

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Mefloquine is an orally administered blood schizontocide for the chemoprophylaxis of malaria in nonimmune travelers. New pharmacokinetic data has shown that food increases the bioavailability of mefloquine. Steady-state pharmacokinetics of weekly prophylaxis in long term travelers have shown that toxic accumulation does not occur and that weekly dosing is associated with protective levels of the drug. The pharmacokinetics of mefloquine are highly stereospecific and all pharmacokinetic parameters, except tmax are significantly different for the (+) and (-) enantiomers. Mefloquine and its metabolite are not appreciably removed by hemodialysis. Steady-state levels of mefloquine can be attained in a reduced time frame of 4 days compared to 7-9 weeks using a loading dose strategy of 250 mg mefloquine daily for 3 days followed thereafter by weekly mefloquine dosage. This strategy, is however, associated with a higher incidence of an adverse event (AE). Cumulative evidence suggests a high protective efficacy of mefloquine (>91%) in nonimmune travelers to areas of chloroquine resistant Plasmodium falciparum (CRPF) except for clearly defined regions of multi-drug resistance. Reports from sub-Saharan Africa indicate a low but increasing level of resistance to this drug. Mefloquine resistance is associated with halofantrine and quinine resistance but not with chloroquine resistance. Penfluridol has been shown to reverse P. falciparum mefloquine resistance in vitro. There is some controversy regarding the tolerabilty of mefloquine for malaria chemoprophylaxis. A review of the studies conducted during 1992-1998 shows that in the reporting of any AE the incidence lies in the range (12-90%) and where there is a comparator, is equivalent to the incidence reported for almost all alternative regimens. When some measure of subjective severity is applied to the rating of AE, it appears that 11-17% of travelers are, to some extent, incapacitated by AE. Major studies and worldwide monitoring have shown that serious events are rare. A recent meta-analysis showed that rates of withdrawal and overall incidence of AE with mefloquine were not significantly higher than those observed with comparator regimens except that mefloquine was more likely to cause insomnia and fatigue. Withdrawals in mefloquine arms were higher than in placebo arms. No performance deficit or functional impairment was observed in five clinical toxicity studies of mefloquine prophylaxis, including a study of driving performance. There is limited data regarding use of mefloquine in pregnancy. Early animal studies have documented teratogenic and embryotoxic effects associated with the use of high dose mefloquine. Two studies have shown a relatively high incidence of spontaneous abortions in mefloquine users. Cumulative evidence, however, is reassuring and has led the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC) to sanction the use of mefloquine in pregnant women during the second and third trimesters. In conclusion, mefloquine...

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Impact of UK malaria prophylaxis policy on imported malaria

Cited by 5 publications

References 3 publications

Perceived Nuisance of Mosquitoes on the Isle of Sheppey, Kent, Uk

Perceived Nuisance of Mosquitoes on the Isle of Sheppey, Kent, Uk

Malaria prevention and stand-by emergency treatment among Japanese travelers

Mefloquine for Malaria Chemoprophylaxis 1992–1998: A Review

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