title: Prognostic significance of rises in parasitaemia during treatment of falciparum malaria.
abstract: Transient rises in parasitaemia occur commonly during the treatment of falciparum malaria but their prognostic significance has not been well defined. Twelve-hourly parasite counts from 133 malaria patients who were ultimately cured were therefore compared with counts from 97 therapeutic failures to determine if increase in parasitaemia was a useful early indicator of poor treatment response. Parasitaemia in both groups frequently rose during the initial 12 h of therapy (41% of all patients), but rising counts thereafter were rarer in treatment successes (P < 0.01). The relative risk of treatment failure was 3.8 if the count was higher at 24 h than 12 h, rose to 7.8 for increases at 48-60 h, and was 13.7 and 19.4 for counts above admission levels at 48 h and 60 h. These data suggest a way to identify patients at high risk of treatment failure.
authors.affiliation: Department of Medicine, Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand.
authors.forename: G
authors.initials: G
authors.lastname: Watt
authors.forename: G D
authors.initials: GD
authors.lastname: Shanks
authors.forename: P
authors.initials: P
authors.lastname: Phintuyothin
mesh_terms: D000962:Antimalarials / Q000627:therapeutic use*; D004338:Drug Combinations; D006801:Humans; D016778:Malaria, Falciparum / Q000188:drug therapy / Q000469:parasitology*; D015767:Mefloquine / Q000627:therapeutic use*; D011379:Prognosis; D011739:Pyrimethamine / Q000627:therapeutic use*; D012307:Risk Factors; D013413:Sulfadoxine / Q000627:therapeutic use*; D013997:Time Factors
chemical_list: D000962:Antimalarials; D004338:Drug Combinations; C001205:fanasil, pyrimethamine drug combination; D013413:Sulfadoxine; D015767:Mefloquine; D011739:Pyrimethamine