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Management of Chloroquine-Resistant Falciparum Malaria

Management of Chloroquine-Resistant Falciparum Malaria Abstract OVER a billion people live in tropical and subtropical areas where malaria is still a serious threat.1,2 The global eradication program has so far succeeded mostly in temperate zones. Resourceful mosquito vectors, through either physiological or behavioral resistance to residual insecticides, together with serious administrative problems, threaten the success of the eradication program.3 The appearance of chloroquine-resistant strains of falciparum malaria in South America and in Southeast Asia compounds the situation.4-9 Studies in volunteers in the United States, with strict controls, provide confirmation of drug resistance.8 Most of these strains are refractory not only to chloroquine, but to other synthetic antimalarials such as quinacrine (Atabrine), chlorguanide, and pyrimethamine.10 In late 1965, outbreaks of falciparum malaria appeared in American, Australian, and Korean troops in South Vietnam. Cases occurred almost exclusively among members of rifle companies who had engaged the Viet Cong in intense combat in the central high-land jungles. Clinical References 1. Tropical Health , National Academy of Science, National Research Council, 1962. 2. World Health Organization document A-16-P and B-3, (March 13,) 1963. 3. Bruce-Chwatt, L.J.: Malaria Research for Malaria Eradication , Trans Roy Soc Trop Med Hyg 59:105-137 ( (Jan) ) 1965.Crossref 4. Young, M.D., and Moore, D.V.: Chloroquine Resistant in Plasmodium Falciparum , Amer J Trop Med Hyg 10:317-320 ( (May) ) 1961. 5. Young, M.D., et al: Drug Resistant P falciparum From Thailand , Amer J Trop Med Hyg 12:305-314 ( (May) ) 1963. 6. Sandosham, A.A.; Eyles, D.E.; and Montgomery, R.: Drug Resistance in Falciparum Malaria in SE Asia, Proceedings of the Seventh International Congress on Tropical Medicine and Malaria, September 1963. 7. Eyles, D.E., et al: P Falciparum Resistant to Chloroquine in Cambodia , Amer J Trop Med Hyg 12:840-843 ( (Nov) ) 1963. 8. Powell, R.D., et al: Studies on a Strain of Chloroquine-Resistant Plasmodium falciparum From Vietnam , Bull WHO 31:379-392, 1964. 9. Blount, R.E.: Malaria: An Unsolved Military Medical Problem , Amer J Med Sci 247:407-411 ( (April) ) 1964.Crossref 10. Tigerft, W.D.: Present and Future Malaria Problems , Milit Med 131( (suppl) ):853-856 (Sept) 1966. 11. Blount, R.E.: Malaria in Vietnam, Special Report to the Surgeon General, Jan 29, 1966. 12. Dennis, L.H.; Eichelberger, J.W., Jr.; and Conrad, M.E.: Coagulation Factors in Drug Resistant Plasmodium falciparum Malaria , Clin Res 14:338 ( (April) ) 1966. 13. Dennis, L.G., et al: A Coagulation Defect and Its Treatment With Heparin in Plasmodium knowlesi Malaria in Rhesus Monkeys , Milit Med 131 ( (suppl) ):1107-1110 (Sept) 1966. 14. Hardaway, R.M.: Syndromes of Disseminated Intravascular Coagulation , Springfield, Ill: Charles C Thomas, Publishers, 1966. 15. McKay, D.G.: Disseminated Intravascular Coagulation , New York: Paul B. Hoeber, Inc., 1965. 16. Devakul, D.; Harinsuta, T.; and Reid, H.A.: 125I-Labelled Fibrinogen in Cerebral Malaria , Lancet 2:886-888, ( (Oct 22) ) 1966.Crossref 17. Brooks, M.H., et al: General Pathophysiology of Chloroquine-Resistant P falciparum Malaria , Amer J Med to be published. 18. McCabe, M.E.: Malaria—A Military Medical Problem Yet With Us , Med Serv J Canada 22:313-332 ( (May) ) 1966. 19. Barry, K.G., and Malloy, J.P.: Oliguric Renal Failure: Evaluation and Therapy by Intravenous Infusion of Mannitol , JAMA 179:510-513 ( (Feb 17) ) 1962.Crossref 20. Segal, A.: The Clinical Use of Dextran Solutions , New York: Grune & Stratton, Inc., 1964. 21. Faris, A.A.; Hardin, C.A.; and Poser, C.M.: Pathogenesis of Hemorrhagic Infarction of the Brain , Arch Neurol 9:468-476 ( (Nov) ) 1963.Crossref 22. McFarland, W.; Galbraith, R.G.; and Miale, A.J.: Heparin Therapy in Auto-immune Hemolytic Anemia , Blood 15:741-747 ( (May) ) 1960. 23. Young, M.D.: " Malaria " in Hunter, G.W., III; Frye, W.W.; and Swartzwelder, J. (eds.): A Manual of Tropical Medicine , ed 4, Philadelphia: W. B. Saunders Company, 1966. 24. Blohm, R.W., Jr.: Notes on Malaria—Past, Present and Future , USARV Medical Newsletter 1:45-47 ( (Aug-Sept) ) 1966. 25. Powell, R.D.: The Chemotherapy of Malaria , Clin Pharmacol Ther 7:48-76 ( (Jan-Feb) ) 1966. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Management of Chloroquine-Resistant Falciparum Malaria

Archives of Internal Medicine , Volume 119 (6) – Jun 1, 1967

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Publisher
American Medical Association
Copyright
Copyright © 1967 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1967.00290240079002
Publisher site
See Article on Publisher Site

Abstract

Abstract OVER a billion people live in tropical and subtropical areas where malaria is still a serious threat.1,2 The global eradication program has so far succeeded mostly in temperate zones. Resourceful mosquito vectors, through either physiological or behavioral resistance to residual insecticides, together with serious administrative problems, threaten the success of the eradication program.3 The appearance of chloroquine-resistant strains of falciparum malaria in South America and in Southeast Asia compounds the situation.4-9 Studies in volunteers in the United States, with strict controls, provide confirmation of drug resistance.8 Most of these strains are refractory not only to chloroquine, but to other synthetic antimalarials such as quinacrine (Atabrine), chlorguanide, and pyrimethamine.10 In late 1965, outbreaks of falciparum malaria appeared in American, Australian, and Korean troops in South Vietnam. Cases occurred almost exclusively among members of rifle companies who had engaged the Viet Cong in intense combat in the central high-land jungles. Clinical References 1. Tropical Health , National Academy of Science, National Research Council, 1962. 2. World Health Organization document A-16-P and B-3, (March 13,) 1963. 3. Bruce-Chwatt, L.J.: Malaria Research for Malaria Eradication , Trans Roy Soc Trop Med Hyg 59:105-137 ( (Jan) ) 1965.Crossref 4. Young, M.D., and Moore, D.V.: Chloroquine Resistant in Plasmodium Falciparum , Amer J Trop Med Hyg 10:317-320 ( (May) ) 1961. 5. Young, M.D., et al: Drug Resistant P falciparum From Thailand , Amer J Trop Med Hyg 12:305-314 ( (May) ) 1963. 6. Sandosham, A.A.; Eyles, D.E.; and Montgomery, R.: Drug Resistance in Falciparum Malaria in SE Asia, Proceedings of the Seventh International Congress on Tropical Medicine and Malaria, September 1963. 7. Eyles, D.E., et al: P Falciparum Resistant to Chloroquine in Cambodia , Amer J Trop Med Hyg 12:840-843 ( (Nov) ) 1963. 8. Powell, R.D., et al: Studies on a Strain of Chloroquine-Resistant Plasmodium falciparum From Vietnam , Bull WHO 31:379-392, 1964. 9. Blount, R.E.: Malaria: An Unsolved Military Medical Problem , Amer J Med Sci 247:407-411 ( (April) ) 1964.Crossref 10. Tigerft, W.D.: Present and Future Malaria Problems , Milit Med 131( (suppl) ):853-856 (Sept) 1966. 11. Blount, R.E.: Malaria in Vietnam, Special Report to the Surgeon General, Jan 29, 1966. 12. Dennis, L.H.; Eichelberger, J.W., Jr.; and Conrad, M.E.: Coagulation Factors in Drug Resistant Plasmodium falciparum Malaria , Clin Res 14:338 ( (April) ) 1966. 13. Dennis, L.G., et al: A Coagulation Defect and Its Treatment With Heparin in Plasmodium knowlesi Malaria in Rhesus Monkeys , Milit Med 131 ( (suppl) ):1107-1110 (Sept) 1966. 14. Hardaway, R.M.: Syndromes of Disseminated Intravascular Coagulation , Springfield, Ill: Charles C Thomas, Publishers, 1966. 15. McKay, D.G.: Disseminated Intravascular Coagulation , New York: Paul B. Hoeber, Inc., 1965. 16. Devakul, D.; Harinsuta, T.; and Reid, H.A.: 125I-Labelled Fibrinogen in Cerebral Malaria , Lancet 2:886-888, ( (Oct 22) ) 1966.Crossref 17. Brooks, M.H., et al: General Pathophysiology of Chloroquine-Resistant P falciparum Malaria , Amer J Med to be published. 18. McCabe, M.E.: Malaria—A Military Medical Problem Yet With Us , Med Serv J Canada 22:313-332 ( (May) ) 1966. 19. Barry, K.G., and Malloy, J.P.: Oliguric Renal Failure: Evaluation and Therapy by Intravenous Infusion of Mannitol , JAMA 179:510-513 ( (Feb 17) ) 1962.Crossref 20. Segal, A.: The Clinical Use of Dextran Solutions , New York: Grune & Stratton, Inc., 1964. 21. Faris, A.A.; Hardin, C.A.; and Poser, C.M.: Pathogenesis of Hemorrhagic Infarction of the Brain , Arch Neurol 9:468-476 ( (Nov) ) 1963.Crossref 22. McFarland, W.; Galbraith, R.G.; and Miale, A.J.: Heparin Therapy in Auto-immune Hemolytic Anemia , Blood 15:741-747 ( (May) ) 1960. 23. Young, M.D.: " Malaria " in Hunter, G.W., III; Frye, W.W.; and Swartzwelder, J. (eds.): A Manual of Tropical Medicine , ed 4, Philadelphia: W. B. Saunders Company, 1966. 24. Blohm, R.W., Jr.: Notes on Malaria—Past, Present and Future , USARV Medical Newsletter 1:45-47 ( (Aug-Sept) ) 1966. 25. Powell, R.D.: The Chemotherapy of Malaria , Clin Pharmacol Ther 7:48-76 ( (Jan-Feb) ) 1966.

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Jun 1, 1967

References