Pharmacokinetics/Pharmacodynamics findings after repeated administration of ARTESUNATE thermostable suppositories (RECTOCAPS) in Vietnamese patients with uncomplicated malaria.

In recent years, Artemisinin and particularly one of its derivatives--Artesunate (ART--has become an essential alternative for treatment of both uncomplicated and severe falciparum malaria in Asia and Africa as well. Therefore, these compounds are still and inccreasingly in the focus of interest because of quick acting of this drug, is able to help even unconscious to overcome the malaria attack, when administered by injection. As an alternative, RECTOCAPS have been developed and their use is meanwhile well established.

[Chemosusceptibility analysis of Plasmodium falciparum imported from Comoros to Marseilles, France in 2001-2003].

Objectives: The aim of this work was to study the chemosensitivity of Plasmodium falciparum strains isolated from patients presenting with malaria after having returned from Comoros Islands in 2002-2003, and hospitalized at the North University Hospital, in Marseilles, France.

Materials And Methods: In vitro drug susceptibility (for strains maintained in culture) and mutation-specific polymerase chain reaction (PCR) assays (for all strains) were performed.

Results: Out of 23 strains kept in culture, 50% were shown to be resistant in vitro to chloroquine, 50% were resistant to pyrimethamine, 40% to cycloguanil, 25% to atovaquone, and 7% to mefloquine.

Validation of chemoprevention of canine monocytic ehrlichiosis with doxycycline.

Epidemiological (cohort follow-up) and laboratory techniques studies were done to validate a programme of chemoprevention of canine monocytic ehrlichiosis (CME) with this molecule. 614 dogs returning to France after having spent at least 4 months in a CME-endemic area (Africa, Guyana, Middle-East, etc.) were the object of systematic serological testing by indirect immunofluorescence (IFA).

Efficacy of antimalarial chemoprophylaxis among French residents travelling to Africa.

Controversy exists about which antimalarial chemoprophylaxis regimen should be used among travellers to Africa: the WHO and other experts recommend the use of mefloquine throughout sub-Saharan Africa, whereas French experts still support the combination of chloroquine and proguanil in most of West Africa (the so-called zone 2 countries). In this case-control study based at a travel clinic, we examined the compliance with antimalarial chemoprophylaxis and its efficacy among travellers to tropical areas. Cases were patients with Plasmodium falciparum malaria (n = 131).

Short report: lack of prediction of amodiaquine efficacy in treating Plasmodium falciparum malaria by in vitro tests.

Amodiaquine (AQ) is currently a major candidate for new antimalarial combinations, although in vivo and in vitro tests have been rarely simultaneously investigated. The efficacy of AQ was assessed at the dose of 30 mg/kg in treating Plasmodium falciparum malaria attacks in 74 children from southeast Gabon, and the in vitro activity of monodesethylamodiaquine (MdAQ), the main metabolite of AQ, was measured against P. falciparum parasites isolated from these children.

[Malaria in military personnel: the case of the Ivory Coast in 2002-2003].

French troops were sent to the Ivory Coast on September 22, 2002 within the framework of Operation Unicorn in response to the political unrest. From September 22 to October 20, a total of 37 cases of malaria were reported, i.e.

[Imported malaria in 2000 in 2 northern Paris hospitals].

The number of travellers in malaria striken areas increases each year (2). The risk of infection is high in Sub-Saharan Africa, but appropriate chemoprophylaxis can reduce the morbidity and mortality rate of malaria. Half of the samples of malaria cases received by the National reference centre of malaria chemosensibility (CNRCP) for chemosensibility analysis came from two hospitals in the north of Paris: Bichat Claude Bernard in Paris and Delafontaine in Saint-Denis.

Inland valley rice production systems and malaria infection and disease in the savannah of Côte d'Ivoire.

In sub-Saharan Africa, lowlands developed for rice cultivation favour the development of Anopheles gambiae s. l. populations.

Profile and evolution of the chemosusceptibility of falciparum malaria imported into France in 2000.

In 2000, the chemosusceptibility of imported malaria was stable in France. All countries of infection considered, the bi-resistance to chloroquine and cycloguanil has not changed from 1996 to 2000. The monotherapy using quinine or mefloquine remains the first-line treatment to falciparum malaria.

Combination of drug level measurement and parasite genotyping data for improved assessment of amodiaquine and sulfadoxine-pyrimethamine efficacies in treating Plasmodium falciparum malaria in Gabonese children.

Many African countries currently use a sulfadoxine-pyrimethamine combination (SP) or amodiaquine (AQ) to treat uncomplicated Plasmodium falciparum malaria. Both drugs represent the last inexpensive alternatives to chloroquine. However, resistant P.

Tolerability of doxycycline monohydrate salt vs. chloroquine-proguanil in malaria chemoprophylaxis.

The resistance of Plasmodium falciparum to the chloroquine-proguanil association (C/P) as antimalarial chemoprophylaxis is becoming increasingly common in Africa. Daily oral doxycycline hyclate 100 mg is effective as malaria prophylaxis. But the hyclate salt's adverse effects combined with the capsule's galenic form are incompatible with good chemoprophylaxis compliance.

[Franco-Vietnamese military cooperation in the field of malaria].

In 1991 after the long period of strife the international community moved on deploying a program for malaria control in Vietnam. At that time epidemiological surveys documented one million cases a year including 4 to 5,000 fatalities. This was the starting point for a military and defense cooperation program between the Vietnamese Army Health Corps and the Tropical Medicine Institute of the French Army Health Corps (French acronym, IMTSSA).

Molecular epidemiology of malaria in cameroon. IX. Characteristics of recrudescent and persistent Plasmodium falciparum infections after chloroquine or amodiaquine treatment in children.

In the absence of a firmly established gene responsible for chloroquine and amodiaquine resistance in Plasmodium falciparum, surveillance of resistance to these first-line drugs in Cameroon needs to be performed by in vivo or in vitro tests for drug resistance. These 2 methodological approaches to define drug resistance were shown to be complementary and concordant in a majority of cases at our study sites, but discordant results may be observed in a few cases, probably as a result of acquired immunity and low plasma drug levels. To further examine the nature of recrudescent and persistent parasitemia after treatment with chloroquine or amodiaquine, the clinical response of children aged < 5 years, presumably with insufficient immune response, was assessed, and the in vitro response of the corresponding isolates was determined if treatment or parasitological failure occurred.

Cardiac effects of amodiaquine and sulfadoxine-pyrimethamine in malaria-infected African patients.

The cardiac effect of amodiaquine and sulfadoxine-pyrimethamine was studied in adult Cameroonian patients with acute uncomplicated Plasmodium falciparum malaria by electrocardiographic monitoring over the course of 7 days. Clinical and parasitological responses were monitored until Day 14. Bradycardia was observed in 16 of 20 amodiaquine-treated patients on Day 2, which corresponds to the time when maximal cumulative plasma concentration is reached, and in 12 of 20 patients on Day 7.

[Prevention and treatment of malaria: in vitro evaluation of new compounds].

One of the current options for reducing the morbidity and mortality of malaria are chemoprophylaxis and chemotherapy. For this reason, the increasing prevalence of strains of Plasmodium falciparum resistant to chloroquine and other antimalarial drugs poses a serious problem for control of malaria. There is an urgent need to find and develop novel compounds and to identify novel chemotherapeutic targets.

[Antimalarial chemoprophylaxis in the French army: development from 1986 to 2001].

In 1999, almost 25,000 French soldiers were deployed in malaria transmission areas. With an incidence of 4.5 p.

[Chemoresistance of Plasmodium falciparum in the urban region of Yaounde, Cameroon. Part 2: Evaluation of the efficacy of amodiaquine and sulfadoxine-pyrimethamine combination in the treatment of uncomplicated Plasmodium falciparum malaria in Yaounde, Cameroon].

The spread of chloroquine resistance or its stabilization at a high level calls for a change in the therapeutic strategy, including a possible replacement of chloroquine. We assessed and compared the efficacy of amodiaquine and sulfadoxine-pyrimethamine in Yaoundé. Of 140 adults and children > 5 years enrolled in the study, 59 in the amodiaquine and 58 in the sulfadoxine-pyrimethamine treatment group were followed until day 14.

[Chemoresistance of P. falciparum in urban areas of Yaounde, Cameroon. Part 1: Surveillance of in vitro and in vivo resistance of Plasmodium falciparum to chloroquine from 1994 to 1999 in Yaounde, Cameroon].

Chloroquine is indicated for the first-line treatment of uncomplicated malaria in most African countries. However, the spread of chloroquine-resistant Plasmodium falciparum requires periodic monitoring. Between 1994 and 1999, we studied the evolution of chloroquine resistance in adults (aged > 15 years) and children aged 5-15 years by using tests of therapeutic efficacy and in vitro assays.

Sequence variations in the genes encoding dihydropteroate synthase and dihydrofolate reductase and clinical response to sulfadoxine-pyrimethamine in patients with acute uncomplicated falciparum malaria.

Mutations in dihydropteroate synthase (DHPS) and dihydrofolate reductase (DHFR) are associated with in vitro resistance to sulfadoxine and pyrimethamine, respectively. The response of 75 patients to sulfadoxine-pyrimethamine was determined, and the genes of the corresponding Plasmodium falciparum isolates were sequenced. Of 12 different unmixed allelic combinations, the triple dhfr mutation Asn-108/Arg-59/Ile-51 was observed in all patients responding with early treatment failure.

[In vitro sensitivity of Plasmodium falciparum isolates from Gabon to chloroquine and cycloguanil].

The in vitro susceptibility of 91 Plasmodium falciparum isolates obtained from malaria-infected children living near Libreville (Gabon) was evaluated against chloroquine and cycloguanil (biologically active metabolite of proguanil), using an isotopic micro-drug susceptibility test. In vitro resistance to chloroquine and cycloguanil was observed in 83% (35/42) and in 38% (30/78) of the patients, respectively. Our data showed that 41% (16/39) of Gabonese field isolates were resistant both to chloroquine and cycloguanil.