Halofantrine, increasingly used for treatment of Plasmodium falciparum malaria, is a normally well-tolerated amino-alcohol with very few side-effects, but torsades de pointes ventricular tachycardia due to halofantrine has been reported in a few patients with a congenital long QT interval (Romano-Ward syndrome). We performed a prospective study of the cardiac effect of halofantrine in 20 patients with 48 h ambulatory electrocardiographic (ECG) monitoring; the halofantrine levels in their serum were also determined. Minimal ECG changes were noted, with lengthening of the QT interval without clinical symptoms. This effect was dose-dependent and can be very severe in cases of pre-existing cardiopathy; it also occurs in patients without any pre-existing cardiopathy. In order to reduce the likelihood of such incidents, which are admittedly rare, we suggest performing electrocardiography on all patients before initiating treatment with halofantrine.

Adult↗

PubMedDate not supplied

[Epidemiology and clinical aspects of imported tropical diseases].

The number of people travelling of the tropical countries is in constant progression and today represents about 5% of the population of the developed countries. Mortality is mainly accidental. Morbidity essentially concerns transmissible diseases. Diarrhoeal symptoms occur in 20-55% of travellers, are bacterial in 2 cases out of 3, and can be prevented. Cholera should soon have an efficient oral vaccine. Hepatitis A is frequent in some travellers (2-3%) and can be prevented by vaccination. Hepatitis E is beginning to be observed. Strongyloidiasis can in some cases evolve to serious complications; it may be latent, so should be sought systematically after any visit to the tropics. Most affections on returning to the industrialised world concern paludism of the Plasmodium falciparum type, leading to a still high mortality rate of 400 per year in Europe, while the preventive and curative means available are sufficient. Any fever should therefore be suspected and suitable treatment given. Other causes of fever are acute viral hepatitis, typhoid fever, the arboviroses, and numerous other conditions. Dermatoses represent the third reason for consultation on returning. These mainly concern pruriginous symptoms with filariases and abnormal hosts being evidenced. Furunculous lesions indicate a diagnosis of cutaneous leishmaniosis or myases. Any form of pruritus should suggest a diagnosis of HIV infection, or pruritus should suggest a diagnosis of HIV infection, or particularly trypanosomiasis. The risk of sexually transmissible disease is overall 6-fold higher in tropical travellers; advice before travelling is therefore of paramount importance. Should a seropositive subject travel to the tropics?(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMedDate not supplied

Fatal cardiac incident after use of halofantrine.

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Adult↗

PubMedDate not supplied

Acute bilharziasis outbreak in a family visiting Mali.

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Acute Disease↗

PubMedDate not supplied

[Ethical issues and preventive vaccination].

Preventive vaccination is one of the most spectacular examples of success in the fight against disease. However, the implementation of vaccination strategies is not dependent solely on identifying appropriate vaccines. It also requires organization and is affected by complex economic issues, which are subject to ethical considerations. These include the mobilization of resources and skills for the common good and the respect of the individual such that the use and acceptability of vaccines are optimized.

AIDS Vaccines↗