Mefloquine for malaria

Article Abstract:

Malaria is an infection caused by protozoan parasites within red blood cells. The parasites may be injected into the blood in the sporozoite form by a mosquito bite or by a blood transfusion. The sporozoite undergoes schizogony, or several divisions in tissues, such as the liver, and after 7 to 10 days invades and destroys the red blood cells. The parasites may be transmitted back to the mosquito during a bite, where they develop into forms that produce the sporozoites. Mefloquine hydrochloride is a new antimalarial agent recently approved for the prevention and treatment of malaria caused by Plasmodium falciparum and P. vivax. Mefloquine is active against most strains of malaria, but has little effect on P. vivax during the liver phase of the parasitic cycle. The drug is absorbed by the gastrointestinal tract, partially broken down by the liver, and eliminated in the bile and feces. Studies have revealed that preventative or prophylactic treatment with mefloquine is effective against 90 to 100 percent of patients with P. falciparum malaria. To prevent resistance to mefloquine, the drug may be given with sulfadoxine and pyrimethamine. Adverse effects of mefloquine are related to dose and include vertigo or dizziness, nausea, light-headedness, gastrointestinal disturbances, nightmares, visual disturbances, and headache. Mefloquine also causes central nervous system toxicity and is teratogenic, or toxic to fetal development and growth. The interactions of mefloquine with other drugs and recommended dosages are discussed. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Drug therapy, Antimalarials

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Mortality from Plasmodium falciparum malaria in travelers from the United States, 1959 to 1987

Article Abstract:

Malaria is an acute and sometimes chronic infectious disease caused by the presence of a protozoan parasite within a patient's red blood cells. Malaria is characterized by cycles of chills, fever, and sweats. The disease involves progressive anemia, enlargement of the spleen, and deposition of a pigment called melanin in various organs, which results from the biological activity of the parasite. The causative organism is transmitted through bites of infected female mosquitoes and can also be transmitted by blood transfusions. Over 1 million United States citizens travel to malaria-endemic areas every year, and several hundred become infected with Plasmodium falciparum, the malaria-causing protozoa most commonly associated with severe illness and death. This review of all malaria fatalities reported to the Centers for Disease Control from 1959 to 1987 assessed the factors that contributed to mortality from Plasmodium falciparum in U.S. travelers. During the review period, a total of 68 deaths from P. falciparum malaria in U.S. citizens were reported, and the number of deaths tended to increase over time during this period. A delay in seeking medical care, misdiagnosis, older age, and failure to take antimalarial medication appeared to have contributed to mortality. It is advised that travellers to malaria-endemic areas consult their physician for antimalarial medication before departure and seek medical care promptly if they become ill during or after their trip. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Travel, Patient outcomes, Mortality, Statistics, Travelers

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