Nabiswa A K, Makokha J D, Godfrey R C, Lore W
Department of Phamacology and Therapeutics, Moi University, Eldoret, Kenya.
East Afr Med J. 1994 Jan;71(1):9-13.
A prospective study on the management of suspected malaria using a protocol on a general medical ward during the months of February and March, 1992 was done and the results compared with those of a retrospective study covering the months of November and December, 1991. The retrospective analysis showed that 78 (65%) from a total of 120 patients received antimalarial drugs despite negative or absent blood smears for malarial parasites. In 41 (34%) of the 120 patients, the first line treatment given was quinine. In the prospective study the overall quinine use dropped sharply to 19% from 54% in the retrospective study. 94 (49%) from a total of 193 patients with suspected malaria had negative blood smears of whom only 8 (4%) received quinine while 63 (33%) did not receive any antimalarial therapy and 38 of these 63 patients ended up with different final diagnoses; the remaining 25 were observed on no antimalarial treatment and discharged home feeling well. These results emphasize the need for proper diagnosis of malaria and suggest that chloroquine is still acceptable and effective as a first line drug for proven cases of malaria in adult patients in Eldoret. Unnecessary quinine use is discouraged as the drug is more expensive with more toxic effects compared to chloroquine.
1992年2月和3月期间，在普通内科病房按照一项方案对疑似疟疾的管理进行了一项前瞻性研究，并将结果与1991年11月和12月的一项回顾性研究结果进行了比较。回顾性分析显示，在总共120例患者中，尽管疟原虫血涂片呈阴性或未检出，但仍有78例（65%）接受了抗疟药物治疗。在120例患者中的41例（34%）中，一线治疗药物为奎宁。在前瞻性研究中，奎宁的总体使用量从回顾性研究中的54%急剧降至19%。在总共193例疑似疟疾患者中，94例（49%）血涂片呈阴性，其中只有8例（4%）接受了奎宁治疗，63例（33%）未接受任何抗疟治疗，这63例患者中有38例最终诊断不同；其余25例未接受抗疟治疗，出院时感觉良好。这些结果强调了正确诊断疟疾的必要性，并表明氯喹作为埃尔多雷特成年疟疾确诊病例的一线药物仍然是可接受且有效的。不鼓励不必要地使用奎宁，因为与氯喹相比，该药物更昂贵且毒性更大。
