Header

UZH-Logo

Maintenance Infos

Stand-by treatment of malaria in travellers: a review


Schlagenhauf, Patricia; Steffen, Robert (1994). Stand-by treatment of malaria in travellers: a review. Journal of tropical medicine and hygiene, 97(3):151-60.

Abstract

Stand-by treatment is the use of anti-malaria drugs carried for self-administration when fever and flu-like symptoms occur and prompt medical attention is not available. This paper aims to review the rationale for the stand-by therapy concept, the range of options available, the factors influencing the choice of therapy and the efficacy and toxicity of the various agents available in the light of ever increasing resistance to conventional drugs. The use of chloroquine as a possible stand-by treatment is limited because of widespread chloroquine resistance and the problem is further compounded by the increasing prevalence of parasites resistant to antifolate/sulpha drug combinations, particularly in South-East Asia and South America. Mefloquine is a promising agent for presumptive malarial treatment with limited foci of drug resistance, notably in Thailand. Mefloquine therapy has been associated with adverse events, mostly minor but with occasional neuropsychiatric events. The use of halofantrine, hitherto often recommended as a stand-by treatment, has been curtailed after recent research reports demonstrated that the drug may cause prolongation of the QTc interval. Current experience with stand-by therapy is limited and studies are in progress to elucidate the exact circumstances under which travellers actually use their emergency medication. Stand-by treatment is an option for clearly defined situations while prophylaxis remains the safest choice for travellers to areas of high transmission.

Abstract

Stand-by treatment is the use of anti-malaria drugs carried for self-administration when fever and flu-like symptoms occur and prompt medical attention is not available. This paper aims to review the rationale for the stand-by therapy concept, the range of options available, the factors influencing the choice of therapy and the efficacy and toxicity of the various agents available in the light of ever increasing resistance to conventional drugs. The use of chloroquine as a possible stand-by treatment is limited because of widespread chloroquine resistance and the problem is further compounded by the increasing prevalence of parasites resistant to antifolate/sulpha drug combinations, particularly in South-East Asia and South America. Mefloquine is a promising agent for presumptive malarial treatment with limited foci of drug resistance, notably in Thailand. Mefloquine therapy has been associated with adverse events, mostly minor but with occasional neuropsychiatric events. The use of halofantrine, hitherto often recommended as a stand-by treatment, has been curtailed after recent research reports demonstrated that the drug may cause prolongation of the QTc interval. Current experience with stand-by therapy is limited and studies are in progress to elucidate the exact circumstances under which travellers actually use their emergency medication. Stand-by treatment is an option for clearly defined situations while prophylaxis remains the safest choice for travellers to areas of high transmission.

Statistics

Citations

30 citations in Web of Science®
34 citations in Scopus®
Google Scholar™

Altmetrics

Additional indexing

Item Type:Journal Article, not refereed, original work
Communities & Collections:04 Faculty of Medicine > Epidemiology, Biostatistics and Prevention Institute (EBPI)
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:June 1994
Deposited On:10 Jun 2016 10:09
Last Modified:08 Dec 2017 19:40
Publisher:Wiley-Blackwell Publishing, Inc.
ISSN:0022-5304
PubMed ID:8007055

Download

Full text not available from this repository.