Abstract
A controlled clinical therapeutic study in hospitalized patients compared artesunate with quinine and mefloquine in patients with uncomplicated falciparum malaria. Forty two patients entered the trial and the follow up was for 28 days with thick blood film taken every 12 hours until became negative. Laboratory examinations included haematological and biochemical tests before and after treatment. Patients had a mean parasitaemia of 42.568 per microliter. Twenty six patients completed 28 days of follow up but 16 did not fulfil this protocol. One in each of the therapeutic groups showed delayed R I resistance. A further patient in the quinine group showed R III resistance. The cure rate was 88.8% for artesunate. 85.7% for mefloquine and 81.8% for quinine; no significant difference was found, the same occurring with the clearance of fever. The artesunate group had a quicker parasitaemia clearance time (37.3 +/- 11.5 hours) when compared with quinine (65.2 +/- 17.4) showing a significant difference (p = 0.0016). Parasite clearance with mefloquine, was intermediate (58.9 +/- 16.6 ours) between the artesunate and quinine. No important side effects were observed with any of the therapeutic regimens and no deaths registered.
Highlights
Foram selecionados quarenta e dois pacientes que procuraram o CEMETRON, com diagnóstico parasitológico realizado pelos técnicos da Fundação Nacional de Saúde e com parasitemia quantificada em duas cruzes de malária falciparum, com residência fixa em Porto Velho e quadro clínico de malária não grave
A controlled clinical therapeutic study in hospitalized patients compared artesunate with quinine and mefloquine in patients with uncomplicated falciparum malaria
The cure rate was 88.8% for artesunate, 85.7% for mefloquine and 81.8% for quinine; no significant difference was found, the same occurring with the clearance of fever
Summary
Foram selecionados quarenta e dois pacientes que procuraram o CEMETRON, com diagnóstico parasitológico realizado pelos técnicos da Fundação Nacional de Saúde e com parasitemia quantificada em duas cruzes de malária falciparum, com residência fixa em Porto Velho e quadro clínico de malária não grave. Foram excluídas as gestantes e os pacientes que usaram drogas antimaláricas nos últimos 15 dias. O quinino (vo) na dose de 10mg/kg/dose a cada oito horas durante três dias. A tetraciclina (vo) na dose de 500mg a cada oito horas, durante sete dias. A contagem parasitária se realizou a cada 12 horas durante a internação e nos dias marcados para o seguimento clínico. Nenhuma droga antimalárica adicional foi usada nos pacientes durante os 28 dias de seguimento. Toda recrudescência após sete dias foi tratada com dose única de mefloquina. Tabela 1 - Características da população de acordo com grupos terapêuticos
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