New aspects of malaria imported from Ethiopia.
We describe a high incidence of Plasmodium vivax malaria among travelers returning from Ethiopia, who all took the recommended prophylaxis. Three groups of 7-11 nonimmune travelers received mefloquine (250 mg weekly), beginning 1-2 weeks prior to departure and continuing for 4 weeks after their return. A fourth group mistakenly took inadequate prophylaxis and is presented for comparison. Vivax malaria occurred at a rate of up to 50% in the first three groups; nearly all patients became ill 3 months after exposure. In the fourth group, primary attacks of both falciparum and vivax malaria occurred within 1 month of return, at an incidence of 50%. The use of mefloquine prevented Plasmodium falciparum infection, but a very high rate of relapses of P. vivax infection occurred. The complexity of prophylaxis for malaria in an area with a high rate of both P. falciparum and P. vivax infections and the urgent need for effective causal prophylaxis are discussed.
Schwartz
E
E
Center of Geographical Medicine, Chaim Sheba Medical Center, Tel Hashomer, Israel.
Sidi
Y
Y
D000818:Animals; D000962:Antimalarials / Q000627:therapeutic use; D002738:Chloroquine / Q000627:therapeutic use; D009033:Culicidae; D004197:Disease Reservoirs; D004359:Drug Therapy, Combination; D005002:Ethiopia; D006801:Humans; D015994:Incidence; D007303:Insect Vectors; D007557:Israel; D016780:Malaria, Vivax / Q000188:drug therapy / Q000453:epidemiology* / Q000517:prevention & control / Q000635:transmission; D015767:Mefloquine / Q000627:therapeutic use; D011319:Primaquine / Q000627:therapeutic use; D014195:Travel
D000962:Antimalarials; D002738:Chloroquine; D011319:Primaquine; D015767:Mefloquine