Relative chloroquine resistance of P falciparum in Zambia.

Abstract

1669Before vitamin D was discovered nutritional rickets was treated by exposure to sunlight.:' We report the successful treatment of osteomalacia by ultraviolet light in a patient with malabsorption and draw attention to the value of this long-established, safe, and unduly neglected form of treatment. Case reportA 42-year-old mentally defective man presented in February 1976 with a one-year history of diarrhoea and loss of weight. He was found to have steatorrhoea and a jejunal biopsy specimen showed partial villous atrophy. Although the steatorrhoea improved on a gluten-free diet (fat excretion falling from 83 mmol/24 h to 27 mmol/24 h; normal < 18 mmol/24 h), complete recovery was never achieved, partly (at least) because of dietary indiscretions. In May 1977 the patient complained of soreness over the ribs and both tibiae for two months. The serum concentration of calcium was 2-08 mmol/1 (8 32 mg/ 100 ml), phosphate 0-67 mmol/l (2-07 mg/100 ml), and alkaline phosphatase 720 IU/l (normal <92 IU/1). A bone biopsy specimen showed wide osteoid seams and a defective calcification front and the plasma 25-OHD concentration was low at 3-9 ng/ml.Whole-body treatment with ultraviolet light was begun in May 1977 using four Westinghouse lamps FS40. The patient was treated three times per week, with increasing exposure times. Within one week of starting treatment (total exposure 20 min) his bone pains had been relieved and after two weeks' treatment (50 min) the plasma 25-OHD concentration had risen to 18 3,/g/l.

Various pfcrt and pfmdr1 Genotypes of Plasmodium falciparum Cocirculate with P. malariae, P. ovale spp., and P. vivax in Northern Angola

“…The national guidelines for malaria treatment changed from CQ to artemether-lumefantrine (AL) in 2004, following WHO 2001 guidelines and high treatment failure rates observed in bordering countries (4,17,23,25,31,48). However, due to difficulties in the wide-scale distribution of AL to health facilities throughout the country, other drugs may have been used until 2007 to 2008, when AL became broadly available (fightingmalaria.gov/technical /acts/angola_acts.html).…”

Safety and efficacy of dihydroartemisinin-piperaquine versus artemether-lumefantrine in the treatment of uncomplicated Plasmodium falciparum malaria in Zambian children

“…Reduced in vivo CQ sensitivity was first reported in 1978 [2] and CQ resistance in 1983 [3]. In 1996, sulphadoxine-pyrimethamine (SP) was recommended by the malaria control programme as rescue treatment if CQ failed [4].…”

Evolution of Plasmodium falciparum drug resistance: implications for the development and containment of artemisinin resistance

“…Chloroquine-resistant P. falciparum that originated along the Thailand-Cambodia border expanded to neighboring countries by the mid1960s, and to central India by the late 1970s (2). Notably, this resistant lineage reached the African continent in 1974 (44) and had dispersed to East Africa by the early 1980s (45)(46)(47)(48), to Central Africa in the mid-1980s (49-51), and to West Africa by the late 1980s (52)(53)(54)(55). The other chloroquine-resistant lineage that originated along the Panama-Colombia border was detected in Brazil in 1961, and had spread to South American endemic regions by the early 1980s (2).…”