[Treatment of Plasmodium falciparum malaria in Africa (except cerebral malaria)].
Chloroquine is currently the drug of choice for treatment of acute attacks of Plasmodium falciparum malaria in chloroquine-sensitive areas. In areas of low level resistance, this drug may still be used (25 mg/kg of body weight in three days) in semi-immune patients. In case of failure, or in areas of high level resistance, quinine (25 mg/kg/day for 3 to 5 days) or, in spite of increasing resistance, Fansidar should be prescribed. Mefloquine, Fansimef and Halofantrine ought to be strictly prescribed to delay occurrence of resistance. Severe attacks require quinine by continuous intravenous infusion. Spleen enlargement does not usually require specific treatment unless poor tolerance is observed. Blood transfusions present a considerable risk of HIV transmission. Appropriate malaria treatment may avoid blood transfusions thus preventing HIV dissemination in Africa.
Institut de Médecine et d'Epidémiologie africaines, Hôpital Bichat, Paris, France.
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Charmot
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JP
Coulaud
D000349:Africa; D000818:Animals; D000962:Antimalarials / Q000008:administration & dosage / Q000627:therapeutic use*; D002985:Clinical Protocols; D004338:Drug Combinations / Q000008:administration & dosage / Q000627:therapeutic use; D004351:Drug Resistance; D006801:Humans; D008288:Malaria / Q000188:drug therapy* / Q000517:prevention & control; D010963:Plasmodium falciparum; D011739:Pyrimethamine / Q000008:administration & dosage / Q000627:therapeutic use; D011804:Quinolines / Q000008:administration & dosage / Q000627:therapeutic use*; D013413:Sulfadoxine / Q000008:administration & dosage / Q000627:therapeutic use
D000962:Antimalarials; D004338:Drug Combinations; D011804:Quinolines; C001205:fanasil, pyrimethamine drug combination; D013413:Sulfadoxine; D011739:Pyrimethamine
Le traitement du paludisme à Plasmodium falciparum en Afrique (à l'exception des formes pernicieuses).