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Falciparum malaria, imported into The Netherlands, 1979-1988. I. Epidemiological aspects.
Trop Geogr Med. 1995; 47(2):53-60.TG

Abstract

From 1979-1988, 427 patients with falciparum malaria were prospectively investigated for chloroquine resistance. About 90% were infected in sub-Saharan Africa. Of the 361 non-immune patients 235 were evaluable; in 158 (67%) chloroquine resistance of Plasmodium falciparum could be confirmed. Chloroquine sensitivity was found in 77 (32%) patients. Sulfadoxine-pyrimethamine resistance was found in 33 patients. The history of use of chemoprophylaxis was recorded in 357 patients: 168 (49%) took adequate, 103 inadequate and 86 no chemoprophylaxis. In 65 of the 168 patients with a history of good compliance, prophylactic serum concentrations could be measured; in 56 (86%) patients the history was confirmed by the chloroquine level. All but one of them were infected with a resistant P. falciparum strain. Of the 66 semi-immune patients, 60 were infected in their homeland; in 5 (8%) chloroquine resistance was found. Only 1 of the 60 patients had used adequate chemoprophylaxis and proved to be infected with a resistant P. falciparum strain. During the study the spread of drug resistance from East Africa to other parts of Africa could be observed. Monitoring for drug-resistant falciparum malaria in travellers returning from malaria-endemic areas is a helpful tool in predicting the evolution of drug resistance in that area. In the non-endemic area such monitoring is essential for optimal advice on treatment of patients and of chemoprophylaxis in travellers.

Authors+Show Affiliations

Unit for Tropical Medicine, Royal Tropical Institute, Amsterdam, The Netherlands.No affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

8592763

Citation

Wetsteyn, J C., and A de Geus. "Falciparum Malaria, Imported Into the Netherlands, 1979-1988. I. Epidemiological Aspects." Tropical and Geographical Medicine, vol. 47, no. 2, 1995, pp. 53-60.
Wetsteyn JC, de Geus A. Falciparum malaria, imported into The Netherlands, 1979-1988. I. Epidemiological aspects. Trop Geogr Med. 1995;47(2):53-60.
Wetsteyn, J. C., & de Geus, A. (1995). Falciparum malaria, imported into The Netherlands, 1979-1988. I. Epidemiological aspects. Tropical and Geographical Medicine, 47(2), 53-60.
Wetsteyn JC, de Geus A. Falciparum Malaria, Imported Into the Netherlands, 1979-1988. I. Epidemiological Aspects. Trop Geogr Med. 1995;47(2):53-60. PubMed PMID: 8592763.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Falciparum malaria, imported into The Netherlands, 1979-1988. I. Epidemiological aspects. AU - Wetsteyn,J C, AU - de Geus,A, PY - 1995/1/1/pubmed PY - 1995/1/1/medline PY - 1995/1/1/entrez SP - 53 EP - 60 JF - Tropical and geographical medicine JO - Trop Geogr Med VL - 47 IS - 2 N2 - From 1979-1988, 427 patients with falciparum malaria were prospectively investigated for chloroquine resistance. About 90% were infected in sub-Saharan Africa. Of the 361 non-immune patients 235 were evaluable; in 158 (67%) chloroquine resistance of Plasmodium falciparum could be confirmed. Chloroquine sensitivity was found in 77 (32%) patients. Sulfadoxine-pyrimethamine resistance was found in 33 patients. The history of use of chemoprophylaxis was recorded in 357 patients: 168 (49%) took adequate, 103 inadequate and 86 no chemoprophylaxis. In 65 of the 168 patients with a history of good compliance, prophylactic serum concentrations could be measured; in 56 (86%) patients the history was confirmed by the chloroquine level. All but one of them were infected with a resistant P. falciparum strain. Of the 66 semi-immune patients, 60 were infected in their homeland; in 5 (8%) chloroquine resistance was found. Only 1 of the 60 patients had used adequate chemoprophylaxis and proved to be infected with a resistant P. falciparum strain. During the study the spread of drug resistance from East Africa to other parts of Africa could be observed. Monitoring for drug-resistant falciparum malaria in travellers returning from malaria-endemic areas is a helpful tool in predicting the evolution of drug resistance in that area. In the non-endemic area such monitoring is essential for optimal advice on treatment of patients and of chemoprophylaxis in travellers. SN - 0041-3232 UR - https://www.unboundmedicine.com/medline/citation/8592763/Falciparum_malaria_imported_into_The_Netherlands_1979_1988__I__Epidemiological_aspects_ L2 - http://www.diseaseinfosearch.org/result/4415 DB - PRIME DP - Unbound Medicine ER -