Chemoprophylaxis malaria

M., Pyrimethamine sustained release systems based on bioresorbable polyesters for chemoprophylaxis of rodent malaria,... 

All travelers to endemic areas should be advised to remain in well-screened areas, to wear clothes that cover most of the body, and sleep in mosquito nets. Travelers should adhere to malaria chemoprophylaxis regimens and carry the insect repellant DEET (N, N,-diethylmetatoluamide) or other insect sprays containing DEET for use in mosquito-infested areas. 

Q38 Chemoprophylaxis of malaria with mefloquine can be undertaken with caution in ... 

Used for malaria chemoprophylaxis and treatment the dihydrofolate reductase inhibitors do not cause pharmacological side-effects in the host. In the higher dose used for toxoplasmosis macrocytic anaemia and other adverse effects may occur. 

Kain KC, Shanks D, and Keystone JS. Malaria chemoprophylaxis in the age of drug resistance. I. Currently recommended drug regimens. Clin Infect Dis 2001 33 226-234. 

Acute malaria PO In combination with sulfonamide-. 25 mg daily for 2 days with a sulfonamide Without concomitant sulfonamide-. 50 mg for 2 days Chemoprophylaxis of malaria PO 25 mg once weekly. 

Chloroquine has been the drug of choice for both treatment and chemoprophylaxis of malaria since the 1940s, but its usefulness against P falciparum has been seriously compromised by drug resistance. It remains the drug of choice in the treatment of sensitive P falciparum and other species of human malaria parasites. 

Standard chemoprophylaxis does not prevent a relapse of vivax or ovale malaria, because the hypnozoite forms of these parasites are not eradicated by chloroquine or other available agents. To markedly diminish the likelihood of relapse, some authorities advocate the use of primaquine after the completion of travel to an endemic area. 

Clindamycin (see Chapter 44) is slowly active against erythrocytic schizonts and can be used after treatment courses of quinine, quinidine, or artesunate in those for whom doxycycline is not recommended, such as children and pregnant women. Azithromycin (see Chapter 44) also has antimalarial activity and is now under study as an alternative chemoprophylactic drug. Antimalarial activity of fluoroquinolones has been demonstrated, but efficacy for the therapy or chemoprophylaxis of malaria has been suboptimal. 

Boggild AK et al Atovaquone-proguanil Report from the CDC expert meeting on malaria chemoprophylaxis (II). Am J Trop Med Hyg 2007 76 208. [PMID 17297027]... 

Petersen E. Malaria chemoprophylaxis when should we use it and what are the options Expert Rev Anti Infect Ther. 2004 2 119-132. 

Shanks GD, Edstein MD. Modern malaria chemoprophylaxis. Drugs. 2005 65 2091-2110. 

Petersen E, Ronne T, Ronn A, Bygbjerg I, Larsen SO. Reported side effects to chloroquine, chloroquine plus proguanil, and mefloquine as chemoprophylaxis against malaria in Danish travelers. I Travel Med 2000 7(2) 79-84. 

Huzly D, Schonfeld C, Beuerle W, Bienzle U. Malaria chemoprophylaxis in German tourists a prospective study on compliance and adverse reactions. J Travel Med 1996 3(3) 148-55. 

Phillips MA, Kass RB. User acceptability patterns for mefloquine and doxycycline malaria chemoprophylaxis. I Travel Med 1996 3(l) 40-5. 

Mefloquine (t) 21 d) is similar in several respects to quinine although it does not intercalate with plasmodial DNA. It is used for malaria chemoprophylaxis, to treat uncomplicated Plasmodium falciparum (both chloroquine-sensitive and chloroquine resistant) and chloroquine-resistant Plasmodium vivax malaria. Mefloquine is rapidly absorbed from the gastrointestinal tract and its action is terminated by metabolism. When used for prophylaxis, 250 mg (base)/week should be taken, commencing 1-3 weeks before entering and continued for 4 weeks after leaving a malarious area. It should not be given to patients with hepatic or renal impairment. 

Prevention of malaria comprises exposure prophylaxis and chemoprophylaxis. 

Esophageal ulceration occurred in two adults taking doxycycline as malaria chemoprophylaxis (13). 

Mefloquine (125 or 250 mg/week n — 56) has been compared with proguanil (100 or 200 mg/day n — 57) for short-term (6 months) malaria chemoprophylaxis in Nigerians with sickle cell anemia in a non-blinded, randomized study (9). Efficacy was similar (89% for mefloquine and 82% for proguanil). Adverse events were reported by 32% of those who took proguanil and 20% of those who took mefloquine. Surprisingly, only 3.6% of the mefloquine group reported neuropsychiatric adverse events. 

Nwokolo C, Wambebe C, Akinyanju O, Raji AA, Audu BS, Emodi IJ, Balogun MO, Chukwuani CM. Mefloquine versus proguanil in short-term malaria chemoprophylaxis in sickle cell anaemia. Clin Drug Invest 200I 2I 537 4. 

Peragallo MS, Sabatinelli G, Sarnicola G. Compliance and tolerability of mefloquine and chloroquine plus proguanil for long-term malaria chemoprophylaxis in groups at particular risk (the military). Trans R Soc Trop Med Hyg 1999 93(l) 73-7. 

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