Stürchler D
Experientia. 1984 Dec 15;40(12):1357-62. doi: 10.1007/BF01951889.
Malaria prevention is a main challenge for physicians, nurses, health officers and tour operators. The attack rate of malaria in travellers is 1-10/10,000 departures, and the case fatality rate of imported malaria is around 0.5/100. Travellers should be informed about the risk they are going to take, how to protect against mosquito bites, about the antimalarials they will have to take and what to do when a malaria breakthrough should occur. The 4-aminoquinolines (chloroquine, amodiaquine) remain the drug of choice for the prevention of Plasmodium vivax and of sensitive P. falciparum infections. The problem is to find an effective and safe drug combination for travellers to areas where P. falciparum is either resistant to chloroquine, to Fansidar (the combination of pyrimethamine plus sulfadoxine) or to both. These travellers will probably best be protected by an individually tailored drug combination, which includes amodiaquine or mefloquine as baseline drugs, and a supplementation with Fansidar, Maloprim (the combination of pyrimethamine with dapsone), paludrine or an antibiotic.
疟疾预防是医生、护士、卫生官员和旅行社经营者面临的主要挑战。旅行者中疟疾的发病率为每10000次出行中有1 - 10例，输入性疟疾的病死率约为0.5%。应告知旅行者他们即将面临的风险、如何预防蚊虫叮咬、需要服用的抗疟药物以及疟疾发作时该怎么做。4 - 氨基喹啉类药物（氯喹、阿莫地喹）仍然是预防间日疟原虫和敏感恶性疟原虫感染的首选药物。问题在于为前往恶性疟原虫对氯喹、 Fansidar（乙胺嘧啶加磺胺多辛的组合）或两者均耐药地区的旅行者找到一种有效且安全的药物组合。这些旅行者可能最好通过个体化定制的药物组合来保护，该组合包括以阿莫地喹或甲氟喹作为基础药物，并辅以Fansidar、Maloprim（乙胺嘧啶与氨苯砜的组合）、氯胍或一种抗生素。
