Brazil malaria treatment

Malaria affects an estimated 270 million people and causes 2—3 million deaths annually, approximately one million of which occur in children under the age of five. While primarily an affliction of the tropics and subtropics, it has occurred as far north as the Arctic Circle. The disease essentially has been eradicated in most temperate-zone countries, but some 1100 cases of malaria in U.S. citizens returning from abroad were reported to the Centers for Disease Control during 1990. Malaria is seen today in Southeast Asia, Africa, and Central and South America. It is on the increase in Afghanistan, Brazil, China, India, Mexico, the Philippines, Sri Lanka, Thailand, and Vietnam. Escalation of the disease is because of the discontinued use of the insecticide DDT which effectively kills mosquito larvae, but has been found to be toxic to Hvestock and wildlife. Also, chloroquine (6), a reUable dmg for the prophylaxis and treatment of falcipamm malaria, is ineffective in many parts of the world because of the spread of dmg-resistant strains. 

Supervised treatment of P. vivax malaria with chloroquine (600 mg on day 1, 450 mg on days 2 and 3) and primaquine (15 mg/day for 14 days) has been studied in 50 patients in a non-endemic area of Brazil in a prospective open trial (3). G6PD status was not checked. The relapse-free cure rate at 6 months was 86%. There were no important adverse events. Risk factors for relapse included lower doses of primaquine. In patients over 60 kg in weight, the dose of primaquine can fall short of recommendations (0.25-0.3 mg/kg/day), and this can contribute to the risk of relapse. 

Mefloquine is a long-acting blood schizontocide with high efficacy against malarial parasites resistant to quinine, chloroquine and sulphonamide-pyrimethamine combinations [124-129], A single oral dose of the drug of 15 mg/kg (with a maximum of 750-1000 mg/adult) produces cure rates above 90%, Detailed clinical trials carried out in Zimbabwe, Thailand, Burma, Brazil and Europe have established mefloquine as an effective drug both for prophylaxis and treatment of vi-vax and falciparum malaria [125-130],... 

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