[A return of endemic malaria to the Netherlands is highly unlikely].

The Netherlands has been free from malaria since the early 1960, due to a combination of factors: active search and treatment of patients and parasite carriers, targeted use of insecticides, changes in farming and in housing of man and cattle, pollution of surface water with phosphates and the fact that surface waters became fresher. These factors reduced the mosquito population that is dependent on brackish water. The Dutch malaria mosquito cannot transmit the parasite of tropical malaria.

Parasitological and haematological responses to treatment of Plasmodium falciparum malaria with sulphadoxine-pyrimethamine in southern Malawi.

In 1993, Malawi introduced sulphadoxine-pyrimethamine (SP) for the treatment of uncomplicated, Plasmodium falciparum malaria and became the first country in Africa to abandon chloroquine for first-time therapy. This decision produced an urgent need to monitor local P. falciparum for resistance to SP and to establish both clinical and parasitological criteria for drug failure.

Falciparum malaria and climate change in the northwest frontier province of Pakistan.

Following a striking increase in the severity of autumnal outbreaks of Plasmodium falciparum during the last decade in the Northwest Frontier Province (NWFP) of Pakistan, the role of climatologic variables was investigated. A multivariate analysis showed that during the transmission season of P. falciparum, the amount of rainfall in September and October, the temperature in November and December, and the humidity in December were all correlated (r2 = 0.

The El Niño Southern Oscillation and the historic malaria epidemics on the Indian subcontinent and Sri Lanka: an early warning system for future epidemics?

The recurrent great malaria epidemics which occurred in the Punjab province of former British India and Ceylon before the introduction of residual insecticides have been related to excessive and failing monsoon rains respectively. In the arid Punjab, rainfall facilitated breeding and increased the lifespan of the mosquito vector and, in the wet part of Ceylon, failing monsoon rains caused rivers to pool, creating more favourable breeding conditions. The periodic fluctuations in monsoon rainfall and epidemic malaria are here explained in relation to the El Niño Southern Oscillation.

A comparison of amodiaquine and chloroquine in the treatment therapy of falciparum malaria in Kenya.

During June to August 1989, 158 symptomatic outpatients with P. falciparum malaria were randomly treated with either amodiaquine or chloroquine 25 mg/kg, divided over three days. Amodiaquine (Camoquin, Parke-Davis) was significantly more effective in terms of the rate of parasite clearance, 2.

The consequences of malaria infection in pregnant women and their infants.

Preliminary results are presented from this study which indicate that 84.8% of pregnant women present at first antenatal visit with anemia (Hb 11g/dl) an 8.7% of their infants (n = 230) have a hemoglobin at birth below 14g/dl.

A study of the consequences of malarial infection in pregnant women and their infants.

An outline is given of a field research study to be undertaken in Malawi to investigate the pattern and consequences of malaria in pregnancy and infants. The central question to be investigated is whether babies born to anaemic mothers in malarious areas are at increased risk of developing anaemia or altered risk for morbidity from malaria or develop anaemia in the first year of life. The framework for the case control and cohort study to be undertaken is outlined.

Reappearance of Plasmodium malariae in Suriname?

Plasmodium malariae has not been reported from Suriname since 1979. In 1989 an increasing number of P. vivax infections among Bush-negroes returning from the eastern part of the interior was reported in Paramaribo.

Flow cytometric screening of blood samples for malaria parasites.

An automated method for the detection and estimation of malaria parasites in blood samples using flow cytometry is presented. In a single-step procedure 50 microliters of blood sample was collected in 1 ml of lysis solution containing formaldehyde, causing red blood cells to lyse while parasites and white blood cells are preserved. Thus prepared, samples could be transported and remained stored in lysis solution until flow cytometric analysis was performed.

[Cutaneous leishmaniasis in 49 patients in The Netherlands].

In a retrospective study the data concerning 49 patients with cutaneous leishmaniasis were analysed. The group included 39 patients seen in Amsterdam in the period 1979-1988 in the Royal Institute for the Tropics and the University Medical Centre and 10 patients seen in the University Hospital of Leiden in the period 1970-1982. Mediterranean countries, especially Spain, were important sources of infection.

Automated flow cytometric analysis of drug susceptibility of malaria parasites.

A method is described for the fully automated reading of Plasmodium falciparum drug susceptibility tests. Cultured material was fixed and could be stored for greater than or equal to 6 months until analysis. The parasites were stained for DNA with the fluorescent dye Hoechst 33258 and analyzed by flow cytometry.

Field evaluation of the use of an ELISA to detect chloroquine and its metabolites in blood, urine and breast-milk.

The evaluation of an enzyme-linked immunosorbent assay (ELISA) for chloroquine and its metabolites in blood, urine and breast-milk is reported. ELISA blood levels, following standard treatment with chloroquine of pregnant and non-pregnant women, showed mean values comparable to other analytical methods. Blood chloroquine concentrations were estimated at day 0, 350-400 ng/ml; day 2, 1000-1500 ng/ml; day 14, 350-400 ng/ml; day 28, 180-350 ng/ml.

Plasmodium berghei: the antimalarial action of artemisinin and sodium artelinate in vivo and in vitro, studied by flow cytometry.

Sodium artelinate, a new water-soluble and relatively stable derivative of artemisinin, and its parent compound were tested for their antimalarial action. Experiments were done in vitro with synchronous cultures of Plasmodium berghei. The inhibition of growth by different concentrations of sodium artelinate and artemisinin was determined using flow cytometry.

Failure of chloroquine prophylaxis for falciparum malaria in pregnant women in Madang, Papua New Guinea.

Six hundred and twenty pregnant women, living under conditions of year-round transmission of malaria in a rural coastal area of Madang, Papua New Guinea (PNG), were followed while attending mobile antenatal clinics and receiving chloroquine prophylaxis (300 mg base weekly). Whole blood chloroquine concentrations measured by ELISA from samples collected at delivery indicated a high level of drug compliance in regular attenders. Susceptibility is increased in primigravidae to Plasmodium falciparum but not to other malaria species, with the peak prevalence occurring at nine to 16 weeks gestation.

Introduction of an improved direct agglutination test for the detection of Leishmania infantum infection in southern France.

An improved direct agglutination test (DAT) is assessed for the detection of Leishmania infantum antibodies in man and in the canine reservoir in Southern France. The test performance in 32 human visceral leishmaniasis patients was in agreement with the parasitological diagnosis and the immunofluorescence (IFAT) results. In six patients diagnosed earlier as kala-azar cases, both DAT and IFAT revealed negative results.