- Controlled Human Malaria Infection: Applications, Advances, and Challenges. [Review]
- IIInfect Immun 2018; 86(1)
- Controlled human malaria infection (CHMI) entails deliberate infection with malaria parasites either by mosquito bite or by direct injection of sporozoites or parasitized erythrocytes. When required,…
Controlled human malaria infection (CHMI) entails deliberate infection with malaria parasites either by mosquito bite or by direct injection of sporozoites or parasitized erythrocytes. When required, the resulting blood-stage infection is curtailed by the administration of antimalarial drugs. Inducing a malaria infection via inoculation with infected blood was first used as a treatment (malariotherapy) for neurosyphilis in Europe and the United States in the early 1900s. More recently, CHMI has been applied to the fields of malaria vaccine and drug development, where it is used to evaluate products in well-controlled early-phase proof-of-concept clinical studies, thus facilitating progression of only the most promising candidates for further evaluation in areas where malaria is endemic. Controlled infections have also been used to immunize against malaria infection. Historically, CHMI studies have been restricted by the need for access to insectaries housing infected mosquitoes or suitable malaria-infected individuals. Evaluation of vaccine and drug candidates has been constrained in these studies by the availability of a limited number of Plasmodium falciparum isolates. Recent advances have included cryopreservation of sporozoites, the manufacture of well-characterized and genetically distinct cultured malaria cell banks for blood-stage infection, and the availability of Plasmodium vivax-specific reagents. These advances will help to accelerate malaria vaccine and drug development by making the reagents for CHMI more widely accessible and also enabling a more rigorous evaluation with multiple parasite strains and species. Here we discuss the different applications of CHMI, recent advances in the use of CHMI, and ongoing challenges for consideration.
- Clinical features and management of Plasmodium knowlesi infections in humans. [Review]
- PParasitology 2018; 145(1):18-31
- Plasmodium knowlesi is a simian malaria of primarily the macaque species of South East Asia. While it was known that human infections could be induced during the years of malariotherapy, naturally oc…
Plasmodium knowlesi is a simian malaria of primarily the macaque species of South East Asia. While it was known that human infections could be induced during the years of malariotherapy, naturally occurring P. knowlesi human infections were thought to be rare. However, in 2004, knowlesi infections became recognized as an important infection amongst human populations in Sarawak, Malaysian Borneo. Since then, it has become recognized as a disease affecting people living and visiting endemic areas across South East Asia. Over the last 12 years, clinical studies have improved our understanding of this potentially fatal disease. In this review article the current literature is reviewed to give a comprehensive description of the disease and treatment.
- Psychiatric effects of malaria and anti-malarial drugs: historical and modern perspectives. [Review]
- MJMalar J 2016 06 22; 15:332
- The modern medical literature implicates malaria, and particularly the potentially fatal form of cerebral malaria, with a risk of neurocognitive impairment. Yet historically, even milder forms of mal…
The modern medical literature implicates malaria, and particularly the potentially fatal form of cerebral malaria, with a risk of neurocognitive impairment. Yet historically, even milder forms of malaria were associated in the literature with a broad range of psychiatric effects, including disorders of personality, mood, memory, attention, thought, and behaviour. In this article, the history of psychiatric effects attributed to malaria and post-malaria syndromes is reviewed, and insights from the historical practice of malariotherapy in contributing to understanding of these effects are considered. This review concludes with a discussion of the potentially confounding role of the adverse effects of anti-malarial drugs, particularly of the quinoline class, in the unique attribution of certain psychiatric effects to malaria, and of the need for a critical reevaluation of the literature in light of emerging evidence of the chronic nature of these adverse drug effects.
- [The embroidery work of the lady at Saint-Anne Hospital]. [Historical Article]
- HSHist Sci Med 2014 Apr-Jun; 48(2):261-6
- In July 1974, a 72 old woman had been a patient for forty years in Sainte-Anne Hospital, Ward C. As she had again a violent brawl with her neighbour patient, she revealed being a tremendous artist. S…
In July 1974, a 72 old woman had been a patient for forty years in Sainte-Anne Hospital, Ward C. As she had again a violent brawl with her neighbour patient, she revealed being a tremendous artist. She had been confined on account of dementia paralytica in the Mecca of malariotherapy, and passionately devoted herself to embroidery. Her fancy work was rather a matter for Jean Dubuffet's art through its perfect expression and deserved being known.
- Profile of patients treated with malariotherapy in a psychiatric hospital in Porto Alegre, Brazil: a historical note. [Journal Article]
- TPTrends Psychiatry Psychother 2014; 36(3):169-72
- CONCLUSIONS: The 19 cases evaluated in this study refer to the first year of application of malariotherapy in HPSP. The statistics available on the total number of dead and cured people over the 10 years this therapy was deployed suggest that the outcomes were better in the subsequent years, possibly due to improvement of technique. As a consequence of this innovative research, which had as its principle reorganizing the central nervous system by using the seizure triggered by malaria fever, other forms of shock therapies were developed, such as insulin therapy, cardiazol shock therapy, and electroconvulsive therapy.
- Healing with malaria: a brief historical review of malariotherapy for neurosyphilis, mental disorders and other infectious diseases. [Historical Article]
- RSRev Soc Bras Med Trop 2014 Mar-Apr; 47(2):260-1
- Malariotherapy--insanity at the service of malariology. [Historical Article]
- APAdv Parasitol 2013; 81:223-55
- From the early 1920s until the advent of penicillin in the mid 1940s, a clinical course of malaria was the only effective treatment of general paresis, a common manifestation of tertiary syphilis tha…
From the early 1920s until the advent of penicillin in the mid 1940s, a clinical course of malaria was the only effective treatment of general paresis, a common manifestation of tertiary syphilis that was nearly always fatal. For a number of reasons, Plasmodium vivax became the parasite species most often employed for what became known as malariotherapy. This provided an opportunity, probably unique in the annals of medicine, to observe and investigate the biology, immunology and clinical evolution of a dangerous human pathogen in its natural host. There is little doubt that the lessons learned from these studies influenced the malaria research and control agendas. It is equally true that over the last 40 years, the insights afforded by malariotherapy have remained largely undisturbed on the dusty shelves of institutional libraries. In this chapter, we broadly review the published data derived from malariotherapy, and discuss its relevance to current challenges of P. vivax epidemiology, immunology and pathology.
- Malariotherapy at Mont Park: the earliest surviving movie of psychiatric treatment in Australia. [Historical Article]
- APAustralas Psychiatry 2013; 21(1):73-5
- CONCLUSIONS: Movie film is a guide to a psychiatric past that is rapidly being forgotten. The Ellery movie is an incentive to collect surviving footage before it is too late.
- Psychiatric gadfly: in search of Reginald Ellery. [Historical Article]
- APAustralas Psychiatry 2012; 20(1):7-13
- CONCLUSIONS: Ellery pioneered malariotherapy and psychoanalysis, mixed with leading intellectuals, including Max Harris, John and Sunday Reed, was a member of the Communist Party, wrote poetry and published widely on a wide range of topics. Ellery was talented, innovative, driven and highly energetic, managing a range of activities aside from his work without difficulty. While his writing talent was questioned by some, there is no doubting his influence on painters such as Albert Tucker and Sidney Nolan and his standing in the intellectual life of Melbourne. Ellery was uncompromising in his public stand on issues such as communism and psychoanalysis, but by the end of his life he was deeply disillusioned. Ellery's autobiography, The Cow Jumped Over the Moon, confirms the impression of a restless and creative mind reluctant to be constrained by conventional orthodoxy, the most eminent Australian psychiatrist of his time. His diverse achievements and talent, now largely forgotten, deserve recognition from a profession that is rapidly losing its links with the historical past.
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- Syphilis, sex and psychiatry, 1789-1925: Part 2. [Historical Article]
- APAustralas Psychiatry 2010; 18(1):22-7
- CONCLUSIONS: By the end of the 19th century, social changes such as population growth, mass migration from Eastern Europe and technological developments led to a great rise in syphilis. By 1900, it was estimated that 5-20% of the population of Europe and the USA had, or would have, syphilis. By 1914, there were over 100,00 new cases and 3 million cases of syphilis in Great Britain. There was a constant interaction between syphilis, prostitution and sexual crime; it was the likely motivation for the Jack the Ripper murders, if not many in the next century. The idea of hereditary syphilis fitted perfectly into the theory of degeneration and coursed through psychiatry and caught the attention of Adolf Hitler, facilitating his antisemitic paranoia. Psychiatric progress passed to the German school, led by Kraepelin who did his first research into the symptoms and course of neurosyphilis. In 1906, Wasserman's serological test for syphilis showed that latent lesions could be present. Any doubt about the cause of syphilis was finally eliminated when Noguchi and Moore demonstrated the presence of treponema pallidum in paretic brains in 1913. German academic psychiatry defined psychiatric practice for the next century but malariotherapy, the first physical treatment in psychiatry, was announced by Julius Wagner-Juarreg in Vienna in 1917, bringing hope to the incurable and destroying the climate of therapeutic nihilism that haunted psychiatry. The first trial of malariotherapy in Australia was done by Reginald Ellery at Mont Park Hospital In 1927 in Melbourne. The discovery of penicillin was a caesura, ending malariotherapy and leading many to regard syphilis as a night-extinct illness, but this turned out to be an illusion. Syphilis is returning in new forms in tandem with the AIDS epidemic. Written-off endlessly by its obituarists, syphilis abides.