Malaria chemoprophylaxis during a long-term stay in an endemic area: experience with mefloquine and chloroquine
- Authors: Solovyev A.I.1, Uskov A.N.1,2, Moskalev A.V.1
-
Affiliations:
- S.M. Kirov Military Medical Academy, Ministry of Defense of the Russian Federation
- Pediatric Research and Clinical Center for Infectious Diseases, Federal Biomedical Agency
- Issue: Vol 10, No 2 (2020)
- Pages: 84-89
- Section: Articles
- URL: https://journals.eco-vector.com/2226-6976/article/view/287526
- DOI: https://doi.org/10.18565/epidem.2020.10.2.84-9
- ID: 287526
Cite item
Abstract
Objective. To study the dynamics of occurrence of side effects of mefloquine and chloroquine after starting their regular prophylactic administration and to determine the optimal duration of a continuous cycle of malaria chemoprophylaxis. Subjects and methods. The authors present the results of following up the armed forces personnel from the Russian aviation group of the United Nations peace-keeping mission in Angola in 1996-1997 and used malaria chemoprophylaxis with mefloquine (250 mg once a week) and chloroquine (300 mg once a week). The military servicemen aged 22 to 53 years were followed up for 6 to 12 months. Results. At 4 months after starting medication administration, the proportion of people with signs of the hypersensitivity of mefloquine and chloroquine was 29.7 and 8.3%, respectively. By the end of the 5th month, that was 35.1 and 10.7%, respectively. The persons sensitive to mefloquine had weakness, nausea, sleep disturbance, signs of depression, and a decline in visual acuity. Weakness, short-lasting headache, tinnitus, and decreased appetite were observed in those who took chloroquine. Conclusion. When choosing a malaria chemoprophylaxis scheme, it is necessary to take into account individual drug sensitivity and the length of stay in an endemic area. As a rule, a continuous cycle of chemoprophylaxis should be planned for a period of not more than 3- 4 months. The package of antimalarial measures should additionally include measures to reduce the risk of infection, to protect against vector attacks, and to ensure early detection and effective treatment in infected people.
Keywords
Full Text
![Restricted Access](https://journals.eco-vector.com/lib/pkp/templates/images/icons/text_lock.png)
About the authors
Alexey I. Solovyev
S.M. Kirov Military Medical Academy, Ministry of Defense of the Russian Federation
Email: solopiter@gmail.com
Alexander N. Uskov
S.M. Kirov Military Medical Academy, Ministry of Defense of the Russian Federation; Pediatric Research and Clinical Center for Infectious Diseases, Federal Biomedical Agency
Email: aouskov@gmail.com
Alexander V. Moskalev
S.M. Kirov Military Medical Academy, Ministry of Defense of the Russian Federation
Email: alexmav195223@yandex.ru
References
- Никитин А.Ф., Соловьев А.И., Усков А.Н., Грашин Р.А. и др. Эпидемическая ситуация по малярии на территории Западной Африки в зоне действия российского контингента миротворческих сил ООН. Вестник Российской военно-медицинской академии 2002; 8(2): 28-30
- Перепелкин В.С., Щербина В.П., Никитин А.Ф. Эпидемиология и профилактика малярии в горнопустынной местности с жарким климатом. Воен.-мед. журн. 1988; 309(6): 39-41
- Knobloch J.U. Long-term malaria prophylaxis for travelers. J. Travel. Med. 2004; 11(6): 374-8. DOI: https://doi. org/10.2310/7060.2004.1920
- Chou A., Chevli C., Fitch R. Ferriprotoporphyrin IX fulfills the criteria for identification as the chloroquine receptor of malaria parasites. Biochemistry 1980; 19(8): 1543-9. doi: 10.1021/bi00549a600.
- Verdier F., Bras J., Clavier F., Hatin I., Blayo M.-C. Chloroquine uptake by Plasmodium falciparum-infected human erythrocytes during in vitro culture and its relationship to chloroquine resistance. Antimicrob. Agents. Chemother. 1985; 27(4): 561-4. DOI: 10.1128/ AAC.27.4.561
- Hasin T., Davidovitch N., Cohen R., Dagan T. ct al. Postexposure treatment with doxycycline for the prevention of tick-borne relapsing fever. N. Engl. J. Med. 2006; 355(2): 148-55. doi: 10.1056/NEJMoa053884
- Brumbaugh M., Price P., Fagan N., Hsieh H. Psychotic mania associated with mefloquine in a bipolar patient. South. Med. J. 2008; 101(5): 550-1. DOI: 10.1097/ SMJ.0b013e318167a9e2
- Telgt D.S., Ven A.J., Schimmer B., Droogleever-Fortuyn H.A., Sauerwein R.W. Serious psychiatric symptoms after chloroquine treatment following experimental malaria infection. Ann. Pharmacother. 2005; 39(3): 551-4. DOI: http://dx.doi.org/10.1345/aph.1E409
- Rabar D., Combemale P., Peyron F. Doxycycline-Induced Photoonycholysis. J. Travel Med. 2004; 11(6): 386-7. DOI: https://doi.org/ 10.2310/7060.2004.19210
- Tabibian J.H., Gutierrez M.A. Doxycycline-induced pseudotumor cerebri. South. Med. J. 2009; 102(3): 310-1. DOI: https://doi.org/10.1097/SMJ. 0b013e31818f98f0
- Lobel H.O., Miani M., Eng T., Bernard K.W. еt al. Long-term malaria prophylaxis with weekly mefloquine. Lancet 1993; 341(8849): 848-51. DOI: https://doi. org/10.1016/0140-6736(93)93058-9
- Yelmo S., Morera-Fumero A., Henry M., Renshaw A., Gracia-Marco R. Mania associated with mefloquine prophylaxis. J. Clin. Psychopharmacol. 2010; 30(3): 339- 41. doi: 10.1097/JCP.0b013e3181de80f8
- Devaux C.A., Rolain J.-M., Colson P., Raoult D. New insights on the antiviral effects of chloroquine against coronavirus: what to expect for COVID-19? Int. J. Antimicrob. Agents 2020. https://doi.org/10.1016/j. ijantimicag. 2020.105938
- Yao X., Ye F., Zhang M., Cui C., Huang B., Niu P. at al. In Vitro Antiviral Activity and Projection of Optimized Dosing Design of Hydroxychloroquine for the Treatment of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Clin. Infect. Dis. 2020. https://doi.org/10.1093/cid/ciaa237
Supplementary files
![](/img/style/loading.gif)