Prevention and treatment of malaria. 1. Analysis of 73 cases of malaria in Japan

Abstract

Seventy-three Japanese cases seen and confirmed by the writers as suffering from malaria from 1966to March, 1973 were reported. Increasing number of the patients was seen from 1969. They weremostly in the 3rd to the 5th decade of life. Analysis of preventive measures taken by these patientsrevealed following facts: 37 cases took no or almost no antimalarial drug regularly while they were inthe endemic areas. Twenty five cases took antimalarial drug regularly; 22 of them became sick as theystopped medication upon returning home to Japan, and 3 became ill as they took chloroquine in Laoswhere chloroquine-resistant P. falciparum was prevalent. Eleven cases took antimalarial drug irregularly.There were two fatal cases, both due to falciparum malaria, who had never taken antimalarialdrug at all.Chloroquine was the drug of choice in vivax, ovale and malariae malarias, but combinations ofsulformethoxine-pyrimethamine (SP) and sulfamonomethoxine-pyrimethamine (MP) were also veryeffective in vivax and ovale malarias. Chloroquine is indicated for falciparum malaria patientsreturning from Africa, Indonesia and New Guinea. SP and MP may be given to falciparum malariapatients in general when the illness is not very severe. The falciparum malaria patients infected inVietnam, Laos, Cambodia, Thailand and Malaysia will benefit more with a combination of SP plusquinine or MP plus quinine, than with either chloroquine or quinine given alone.