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[加姆卡利诊所和尼日利亚武装部队疟原虫监测点(尼亚美,尼日尔)恶性疟原虫对氯喹的敏感性]

[Chloroquine sensitivity of Plasmodium falciparum at the Gamkalley Clinic and the Nigerian armed forces PMI (Niamey, Niger)].

作者信息

Parola P, Ali I, Djermakoye F, Crassard N, Bendavid C, Faugère B, Condomines P

机构信息

Clinique Gamkalley, Niamey, République du Niger.

出版信息

Bull Soc Pathol Exot. 1999 Dec;92(5):317-9.

Abstract

In vivo tests for Plasmodium falciparum were carried out in 1998 during the rainy season among children in Niamey, in the Republic of Niger. Chloroquine was prescribed at 25 mg/kg for 3 days in febrile patients with uncomplicated P. falciparum malaria. Forty-five 1-5 year-olds and thirty-three 6-15 year-olds were included in the study. A group of 53 adult patients was also surveyed to evaluate the efficacy of chloroquine in semi-immune persons. Body temperature and blood smears including parasitemia were recorded on days 0, 3, 7 and 14. Less than 10% of the patients were delinquent. Around 75% of the patients were successfully treated in the 1-5 year-olds and 6-15 year old age groups. Relapses were observed in 20% of the 1-5 year-olds (early relapses 8.9%, late relapses 11.1%) and in 16.7% in the 1-15 year-olds (early relapses 6.4%, late relapses 10.3%). Among adults, successful treatment was obtained in 86.8% of the cases and early and late relapses were respectively observed in 3.8% and 1.9% of the cases. All the patients with malaria relapses were cured with second-line treatments (pyrimethamine-sulfadoxine or quinine). According to these results, chloroquine resistance appears to be moderate in Niamey. Therefore chloroquine should remain the first line treatment of uncomplicated P. falciparum malaria in this population.

摘要

1998年雨季期间,在尼日尔共和国尼亚美对儿童进行了恶性疟原虫的体内试验。对于患有非复杂性恶性疟原虫疟疾的发热患者,按25毫克/千克的剂量服用氯喹,疗程为3天。该研究纳入了45名1至5岁的儿童和33名6至15岁的儿童。还对一组53名成年患者进行了调查,以评估氯喹在半免疫人群中的疗效。在第0、3、7和14天记录体温和血涂片(包括寄生虫血症)。不到10%的患者未遵守医嘱。在1至5岁和6至15岁年龄组中,约75%的患者得到成功治疗。在1至5岁的儿童中,20%出现复发(早期复发8.9%,晚期复发11.1%);在6至15岁的儿童中,16.7%出现复发(早期复发6.4%,晚期复发10.3%)。在成年人中,86.8%的病例获得成功治疗,早期和晚期复发分别见于3.8%和1.9%的病例。所有疟疾复发患者均通过二线治疗(乙胺嘧啶-磺胺多辛或奎宁)治愈。根据这些结果,尼亚美的氯喹耐药性似乎为中度。因此,氯喹应仍然是该人群中非复杂性恶性疟原虫疟疾的一线治疗药物。

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