Biomedical subjects
J C Wetsteyn
Publications and source records attributed to J C Wetsteyn.
Parasitological, clinical and haematological response of children with Plasmodium falciparum to 4-aminoquinolines and to pyrimethamine-sulfadoxine with quinine in western Kenya.
Children with Plasmodium falciparum infections in Western Province, Kenya, were studied in 1987 for their parasitological, clinical and haematological response to chloroquine, to amodiaquine and to pyrimethamine-sulfadoxine plus quinine. Ninety-eight children under 5 years of age were treated in 1 of 2 hospitals. Of the 56 patients treated with chloroquine base 25 mg/kg, 91% had resistant infections, with 36% having no significant decrease in parasitaemia (RIII resistance); however, 69% responded clinically within a week. Of the 27 patients treated with amodiaquine base 25 mg/kg, 67% had resistant infections, with 7% RIII resistant; 81% responded clinically. The parasites cleared in all 15 children given pyrimethamine-sulfadoxine plus 3 days of quinine. Only when parasites cleared did patients have improved haemoglobins and haematocrits. This study shows that parasitaemia in children hospitalized in western Kenya responds poorly to 4-aminoquinolines, although the patients improve clinically, at least during the first 7 days. Young children may need to clear parasites to avoid the risk of severe anemia and the need for blood transfusions.
Chloroquine resistance of Plasmodium falciparum in Bukumbi, Tanzania. An in vivo study.
The sensitivity of Plasmodium falciparum to chloroquine was studied in 42 children in Bukumbi, Tanzania. The standard WHO in vivo test was used, and chloroquine phosphate 25 mg base/kg was administered in divided doses over three days. From the 42 patients 13 (31%) were sensitive to chloroquine and 29 (69%) had not cleared their parasites on day 7. From the resistant cases, 1 showed RI resistance (early recrudescence), 6 showed RII resistance and 18 cases showed RIII resistance. Four were resistant, not further specified. This high degree of resistance might indicate that chloroquine, without control of the intake and uptake, is no longer the drug of choice for this area.
The pharmacokinetics of artemisinin after oral, intramuscular and rectal administration to volunteers.
The pharmacokinetics after oral, intramuscular and rectal administration of artemisinin, a new potent antimalarial drug, to healthy volunteers has been examined. The study was set-up as a four-way cross-over design with a wash-out period of one week between the test days. In ten volunteers artemisinin concentrations in serum were monitored using a reversed phase HPLC assay with UV detection after derivatization. After oral administration, artemisinin was rapidly but incompletely absorbed, the mean absorption time was 0.78 h and the bioavailability relative to the intramuscularly injected suspension in oil 32%. The mean residence time of the latter (10.6 h) was 3 times that of the oral formulation (3.4 h). This seems to enable a twice daily dosage regimen for the intramuscular oil injection, while the oral formulation necessitates a more frequent dosing interval. After intramuscular injection and rectal administration of an aqueous suspension, very low and variable artemisinin concentrations in serum were observed, probably indicating a poor and erratic absorption.
[Corticosteroids in the treatment of severe typhoid].
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Chloroquine-resistant falciparum malaria imported into the Netherlands.
A prospective study of imported chloroquine-resistant falciparum malaria in the Netherlands is described. From 1979 to 1983, 77 non-immune patients were investigated; in 41 (53%) decreased sensitivity of Plasmodium falciparum to chloroquine could be confirmed. Signs and symptoms in these patients differ from the classical picture. Resistance to sulfadoxine-pyrimethamine (Fansidar) was established in 6 patients. Parasitaemia was found twice during dapsone-pyrimethamine (Maloprim) prophylaxis. The implications for advice on treatment and prophylaxis are discussed.
[Loaiasis as an imported disease in the Netherlands].
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[A leg ulcer from the tropics caused by Corynebacterium diphtheriae?].
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Hypercalcaemia complicating chronic granulocytic leukaemia (CGL).
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