Interaction of tolbutamide with phenothiazines and diphenhydramine.
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Adult↗
Biomedical subjects
A Menon
Publications and source records attributed to A Menon.
Cellular immune responses to Plasmodium falciparum antigens in children receiving long term anti-malarial chemoprophylaxis.
Fifty-two Gambian children who had received fortnightly chemoprophylaxis with maloprim, (pyrimethamine and dapsone), and 45 receiving placebo, were studied. Cellular immune responses to malaria antigens, measured by lymphoproliferative responses and interferon production, were higher in children who had received prophylaxis than in controls, although the anti-malarial antibody levels were lower. During a one-year period after termination of prophylaxis, there was no increase in the frequency of clinical episodes of malaria in the children who had received Maloprim. These results suggest that chemoprophylaxis for 3 years may lower malaria antibody levels, but does not interfere with the development of protective immunity, perhaps by enhancing cell-mediated immune responses to malaria in protected children.
Animals↗
Lack of an association between acute gastroenteritis, acute respiratory infections and malaria in young Gambian children.
The incidence of acute gastrointestinal and acute respiratory infections was measured in 2 groups of approximately 750 Gambian children aged 3-59 months during a 3-year period. One group of children was partially protected against malaria by fortnightly chemoprophylaxis with Maloprim whilst children in the other group were infected much more frequently. Mortality from acute gastroenteritis and from acute respiratory infections was similar in the 2 groups. The proportions of children in each group who complained of gastrointestinal or severe respiratory symptoms on morbidity surveillance were also similar. Thus, no evidence was found to suggest that malaria plays either a direct or indirect role in causing acute gastrointestinal or respiratory infections in young children in The Gambia.
Acute Disease↗
A comparative study of Lapudrine (chlorproguanil) and Maloprim (pyrimethamine and dapsone) as chemoprophylactics against malaria in Gambian children.
A comparison has been made of Lapudrine (chlorproguanil) and Maloprim (pyrimethamine +dapsone) as malaria chemoprophylactics when given every two weeks for 3 years to Gambian children under the age of 5 years. Both drugs produced falls in spleen and malaria parasite rates and an increase in packed cell volume. Maloprim, but not chlorproguanil, significantly reduced the incidence of episodes of fever accompanied by malaria parasitaemia. Children who received Maloprim, but not those who received chlorproguanil, grew better than children in the placebo group. This finding suggests that brief clinical episodes of malaria are more important in impairing growth than more prolonged periods of asymptomatic parasitaemia. No serious side-effect attributable to either drug was observed. After chemoprophylaxis had been given for 3 malaria transmission seasons the level of resistance of Plasmodium falciparum to pyrimethamine and to chlorproguanil was about 10%.
Animals↗
Sustained protection against mortality and morbidity from malaria in rural Gambian children by chemoprophylaxis given by village health workers.
Mortality and morbidity from malaria were measured in children for a one-year period in a rural area of The Gambia 3-4 years after the introduction of a primary health care programme into some villages in the study area. Among children resident in primary health care villages who received treatment for febrile illnesses from a village health worker resident in their village there was no reduction in overall mortality or in morbidity from malaria compared with levels found in villages without a primary health care worker. However, among children aged 3-59 months who received malaria chemoprophylaxis from a village health worker in addition to treatment there was a 49% reduction in mortality and a 73% reduction in attacks of clinical malaria. The level of protection against malaria achieved by chemoprophylaxis given by village health workers 3-4 years after the chemoprophylaxis programme was started was as high as that obtained shortly after the introduction of the primary health care programme.
Antimalarials↗
A national survey of the prevalence of chloroquine resistant Plasmodium falciparum malaria in The Gambia.
In The Gambia, 760 children less than 10 years of age with Plasmodium falciparum malaria were treated with chloroquine (25 mg/kg) and followed-up 2 and 9 d after the start of treatment. 700 children (92.1%) completed the study. The level of in vivo resistance to chloroquine varied by area from 0.4% to 16.4%. Of the 28 children found to have chloroquine resistant malaria, none was ill when seen at the 9 d follow-up and only 3 (10.3%) required further treatment with alternative antimalarials because of persistent high levels of parasitaemia. However, the fact that 30.4% of the children who completed the study had chloroquine in their urine at presentation may have masked the true level of resistance and led to underestimation of the clinical significance of these findings. The blood film at day 2 did not usefully predict resistance. 67 isolates were tested in vitro for chloroquine sensitivity. The mean EC50 was 15.5 nmol/litre, an eight-fold decrease in sensitivity from that of isolates tested in 1982. 8 (11%) of the isolates had EC50s above the WHO reference value for sensitive isolates of 18.3 nmol/litre, with values ranging from 22 to 65 nmol/litre of culture medium. Gambian isolates were sensitive to quinine (mean EC50 = 49.6 nmol/litre).
Animals↗
Mortality and morbidity from malaria after stopping malaria chemoprophylaxis.
Gambian children who had received malaria chemoprophylaxis for a variable period of time during their first 5 years of life were followed to determine whether they experienced a rebound in mortality or in morbidity from malaria during the period after chemoprophylaxis was stopped. The risk of dying between the ages of 5 years, when chemoprophylaxis was stopped, and 10 years was no higher among children who had received chemoprophylaxis with Maloprim (pyrimethamine plus dapsone) for some period during their first 5 years of life than among children who had received placebo (21 vs. 24 deaths) and the beneficial effect of chemoprophylaxis on mortality observed during the first 5 years of life was sustained. The incidence of clinical attacks of malaria during the year after medication was stopped was significantly higher among children who had previously received Maloprim for several years than among children who had previously received placebo. However, at the end of this year, there was no significant difference in spleen rate, parasite rate or packed cell volume between the 2 groups of children. Thus, stopping chemoprophylaxis after a period of several years increased the risk of clinical malaria but did not result in a rebound in mortality in Gambian children. However, the number of deaths recorded was small, so a modest effect on mortality cannot be excluded.
Animals↗
Incidence of type 1 diabetes mellitis in children aged under 15 years in the Republic of Ireland.
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Adolescent↗
Resources used by general practitioners for advising travelers from New Zealand.
BACKGROUND: The risks of the destination and any specific requirements for travel health advice may be obtained from a variety of resources. This study was designed to investigate the usefulness of various resources available in New Zealand for providing travel health advice and the extent to which GPs used these resources in providing travel health advice. METHOD: Four hundred GPs (400/2830) were randomly selected from the register of the New Zealand Medical Council and sent self-administered questionnaires. Two reminders were sent. RESULTS: Three hundred and thirty-two (332/400, 83%) GPs responded. The usefulness of various resources was reported, including Health Advice for Overseas Travellers (277/289, 96%), New Ethicals (256/278, 92%), New Zealand Public Health Report (79/164, 48%), International Travel and Health (41/144, 28%), computerized databases (6/122, 5%), journals (14/130, 11%), and other resources (44/139, 32%). Health Advice for Overseas Travellers was regarded as significantly more useful than International Travel and Health (x2 = 4,68, df = 1, p <.05). Only 23% (70/309) of respondents indicated that they always used these resources in their practice of travel medicine. Fifty percent (154/309) of respondents indicated that they usually used these resources, while 27% (83/309) of respondents indicated that they used these resources sometimes. Only 1% (2/309) of GPs did not use resources at all for their practice of travel medicine. CONCLUSIONS: The most useful resource was Health Advice for Overseas Travellers, which outlines the New Zealand recommendations for medical practitioners providing travel health advice. It may be useful for GPs to gain access to and training in association with a greater range of specialist resources to use in conjunction with the provision of travel health advice. These might include international guidelines, journals, and access to computerized databases and the internet. With the recent introduction of a widely accessible computerized database in New Zealand, follow-up studies could be instituted to determine if GPs' use of computerized databases becomes more widespread and whether access to and use of these computerized databases influences the provision of travel health advice by GPs. Further studies are needed to examine the appropriateness of the advice provided by the various resources used by GPs in New Zealand.
Communications Media↗