Population pharmacokinetics of mefloquine given as a 3-day artesunate-mefloquine in patients with acute uncomplicated Plasmodium falciparum malaria in a multidrug-resistant area along the Thai-Myanmar border.

Background: Low mefloquine exposure has been shown to contribute to treatment failure in patients with uncomplicated falciparum malaria following a 3-day artesunate-mefloquine combination. The present study aimed to develop a population pharmacokinetic model for mefloquine based on whole blood concentration-time profiles of this target population for further dose optimization.

Methods: A total of 129 Burmese patients aged above 15 years who presented with typical symptoms of malaria and had a blood smear positive for Plasmodium falciparum were included in the study.

Pharmacokinetic properties of intramuscular versus oral syrup paracetamol in Plasmodium falciparum malaria.

Background: Fever is an inherent symptom of malaria in both adults and children. Paracetamol (acetaminophen) is the recommended antipyretic as it is inexpensive, widely available and has a good safety profile, but patients may not be able to take the oral drug reliably. A comparison between the pharmacokinetics of oral syrup and intramuscular paracetamol given to patients with acute falciparum malaria and high body temperature was performed.

Population pharmacokinetics of a three-day chloroquine treatment in patients with Plasmodium vivax infection on the Thai-Myanmar border.

Background: A three-day course of chloroquine remains a standard treatment of Plasmodium vivax infection in Thailand with satisfactory clinical efficacy and tolerability although a continuous decline in in vitro parasite sensitivity has been reported. Information on the pharmacokinetics of chloroquine and its active metabolite desethylchloroquine are required for optimization of treatment to attain therapeutic exposure and thus prevent drug resistance development.

Methods: The study was conducted at Mae Tao Clinic for migrant worker, Tak province, Thailand.

Expression of metallothionein isoforms in peripheral blood leukocytes from Thai population residing in cadmium-contaminated areas.

Metallothionein (MT) is a group of proteins with high cadmium (Cd) affinity and with a potential role in Cd transportation and detoxification. The aim of the present study was to investigate the relationship between MT (MT-1A, MT-2A, and MT-3 isoforms) gene expression level in peripheral blood leukocytes and Cd-associated renal injury in non-occupational exposed Thai population. The study was conducted in adult subjects residing in Cd-contaminated areas of Mae Sot District, Thailand.

Urinary and blood cadmium levels in relation to types of food and water intake and smoking status in a Thai population residing in cadmium-contaminated areas in Mae Sot.

Human exposure to cadmium (Cd) produces a wide variety of toxic effects involving many organs and systems, but the kidney is the main organ affected among long-term Cd-exposed people. In the general population, the primary sources of Cd exposure are cigarette smoke and food (shellfish, offal and certain vegetables). The aims of the study were to investigate the association between urinary and blood Cd levels and personal habits relating to Cd intake (consumption of food stuff, water and tobacco smoking), levels of renal biomarkers in the urine or serum of 314 Thai subjects (85 males, 229 females) who resided in Cd-contaminated areas of Mae Sot District, Tak Province, Thailand.

Study on the association between environmental cadmium exposure, cytochrome P450-mediated 20-HETE, heme-oxygenase-1 polymorphism and hypertension in Thai population residing in a malaria endemic areas with cadmium pollution.

The aims of the study were to investigate (i) the effects of environmental cadmium (Cd) on hypertension, biological markers of renal dysfunction and renal cytochrome P450-mediated arachidonate metabolism; and (ii) the association between genetic polymorphism of heme oxygenase-1 (HO-1) and hypertension and Cd-induced renal injury in the exposed Thai population. The study was conducted in adult subjects residing in Cd-contaminated malaria endemic areas of Mae Sot District, Thailand. All subjects were randomly selected and consistently distributed for sex, age and residential areas.

Distribution of mefloquine in the blood of Thai patients with acute uncomplicated falciparum malaria following administration of therapeutic doses of artesunate.

Purpose: The study objectives to investigate the distribution of the antimalarial drug mefloquine (MQ) in cellular and fluid blood compartments when given at therapeutic dosage with artesunate and to investigate an eventual association with the occurrence of treatment-related adverse events in Thai patients with acute uncomplicated falciparum malaria.

Methods: MQ distribution following administration of standard therapeutic doses (1,250 mg MQ in split dose) with artesunate to 20 Thai patients with acute uncomplicated falciparum malaria was assessed in whole blood, serum, plasma, red blood cells (RBC), white blood cells (WBC), and platelets using high -performance liquid chromatography.

Results: All patients responded to treatment without reappearance of parasitemia during the 42-day follow-up period.

Monitoring of clinical efficacy and in vitro sensitivity of Plasmodium vivax to chloroquine in area along Thai Myanmar border during 2009-2010.

Background: In Thailand, the proportion of Plasmodium vivax infection has become equal to Plasmodium falciparum. Reports of a trend of gradual decline of in vitro sensitivity of P. vivax to chloroquine in some areas of the country, together with accumulating evidences of chloroquine resistance P.

Assessment of in vitro sensitivity of Plasmodium vivax fresh isolates.

Objective: To compare the applicability of the SYBR Green-I assay with the standard schizont maturation assay, for determination of sensitivity of Plasmodium vivax (P. vivax) to chloroquine and a new antifolate WR 99210.

Methods: The study was conducted at Mae Tao Clinic for migrant workers, Tak Province during April 2009 to July 2010.

Declining in efficacy of a three-day combination regimen of mefloquine-artesunate in a multi-drug resistance area along the Thai-Myanmar border.

Background: Declining in clinical efficacy of artesunate-mefloquine combination has been documented in areas along the eastern border (Thai-Cambodian) of Thailand. In the present study, the clinical efficacy of the three-day combination regimen of artesunate-mefloquine as first-line treatment for acute uncomplicated falciparum malaria in Thailand was monitored in an area along the western border (Thai-Myanmar) of the country.

Methods: A total of 150 Burmese patients (85 males and 65 females) aged between 16 and 50 years who were attending the Mae Tao clinic, Mae-Sot, Tak Province, and presenting with symptomatic acute uncomplicated Plasmodium falciparum malaria were included into the study.

The influence of iron stores on cadmium body burden in a Thai population.

Cadmium is a toxin of increasing public health concern due to its presence in most human foodstuffs and in cigarette smoke. Exposure to cadmium leads to tissue bioaccumulation and, in particular, has nephrotoxic effects. The aim of the present study was to investigate the association between cadmium body burden and iron stores in a Thai population.

Cadmium exposure in Thai populations from central, northern and northeastern Thailand and the effects of food consumption on cadmium levels.

The aim of the present study was to investigate the association between cadmium body burden and the areas of exposure in Thailand, as well as blood pressure levels, the types and frequencies of foods, and alcohol consumption. A total of 182 healthy adult Thai subjects of both genders (89 males, 93 females) ages 18 to 57 years old weighing 40-95 kg were included in this study. Participants were residents from three main areas of Thailand: Pathum Thani Province (central Thailand; n=50), Khon Kaen Province (northeastern Thailand; n=43) and Mae Sot District, Tak Province (northern Thailand; n=89).

Identification of HLA-A24 restricted pre-erythrocytic stage specific T-cell epitopes using Plasmodium falciparum synthetic peptides: a preliminary study.

Fourteen (9 amino acids) peptides of Plasmodium falciparum pre-erythrocytic stage antigens, namely, TRAP, CTRP, LSA-1, STARP and MSP-1, restricted to HLA-A24 and specific to T-cell response were identified. The antigen-specific IFN-gamma responses of these synthetic peptides in malaria exposed and non-malaria exposed healthy adult volunteers were detected using the ex vivo ELISPOT assay. Five peptides from TRAP and CTRP antigens significantly increased IFN-y responses of 1/9 in malaria-exposed volunteers.

Pharmacokinetics and pharmacodynamics of fosmidomycin monotherapy and combination therapy with clindamycin in the treatment of multidrug resistant falciparum malaria.

Background: The study investigated the pharmacokinetics of fosmidomycin when given alone and in combination with clindamycin in patients with acute uncomplicated falciparum malaria.

Methods: A total of 15 and 18 patients with acute uncomplicated Plasmodium falciparum malaria who fulfilled the enrollment criteria were recruited from out-patient department of Mae Sot Hospital, Tak Province, Thailand. Patients were treated with monotherapy with fosmidomycin at the dose of 1,200 mg every 8 hours for 7 days (n = 15) or combination therapy with fosmidomycin (900 mg every 12 hours for 7 days) and clindamycin (600 mg every 12 hours for 7 days) (n = 18).

Clinical-parasitological response and in-vitro sensitivity of Plasmodium vivax to chloroquine and quinine on the western border of Thailand.

This study was conducted during 2002-2004 at Mae Sot District, on the Thai-Myanmar border, an area of multidrug-resistant Plasmodium falciparum malaria. Sixty-two patients with P. vivax malaria were included in the study.