[Retrospective analysis of 107 imported adult cases of malaria. Experience report of uncomplicated falciparum malaria treatment in adults with oral atovaquone-proguanil].

Abstract

OBJECTIVES:

The principal aim of this study was to assess the efficacy of the combination of oral atovaquone and proguanil (AP) in routine treatment of uncomplicated falciparum malaria in recent visitors to the tropics. We also analyzed the epidemiologic, clinical and hematologic characteristics of these patients with imported malaria.

METHODS:

This retrospective study reviewed the records of 107 cases of imported malaria, treated in the Tropical Disease Unit of Bordeaux University Hospital (France).

RESULTS:

More than 75% had uncomplicated falciparum malaria; 10 developed complications, and one died. Average time from fever onset to first medical consultation was 4.8 days. Less than 10% had used physical measures of prevention against mosquito bites, and nearly 65% had not used chemoprophylaxis. The most frequent hematologic abnormalities were eosinopenia (84%) and thrombocytopenia (75%). In more than 30% of cases, another disease was also present. The oral AP combination was administered to more than 86% of patients with uncomplicated falciparum malaria (n=72). Tolerance was excellent and only one treatment failure was observed, associated with digestive disorders.

CONCLUSION:

Better information for travelers and general practitioners is required to reduce the number of cases of imported malaria and to shorten the delay between symptom onset and specific treatment. The oral AP combination appears to be a safe and effective treatment for uncomplicated imported falciparum malaria.

• Authors: Rémy Vatan, Thierry Pistone, Pascal Millet, Gabriel Etienne, Patrick Mercié, Maïté Longy-Boursier, Denis Malvy
• Journal: Presse medicale (Paris, France : 1983) (Presse Med) Vol. 35 Issue 4 Pt 1 Pg. 571-7 (Apr 2006) ISSN: 0755-4982 [Print] France
• Vernacular Title: Analyse rétrospective de 107 cas de paludisme d'importation chez l'adulte. Intérêt de l'association orale atovaquone-proguanil dans le traitement de l'accès simple à Plasmodium falciparum.
• PMID: 16614596 (Publication Type: English Abstract, Journal Article)

Chemical References

• Antimalarials
• Drug Combinations
• Proguanil

Topics

• Administration, Oral
• Adolescent
• Adult
• Aged
• Antimalarials (administration & dosage, therapeutic use)
• Diagnosis, Differential
• Drug Combinations
• Eosinophils (metabolism)
• Female
• Fever (diagnosis, epidemiology)
• France (epidemiology)
• Health Status
• Humans
• Malaria, Falciparum (diagnosis, drug therapy, epidemiology)
• Male
• Middle Aged
• Proguanil (administration & dosage, therapeutic use)
• Thrombocytopenia (epidemiology)
• Travel