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Susceptibility of Plasmodium falciparum to different doses of quinine in vivo and to quinine and quinidine in vitro in relation to chloroquine in Liberia.

Chloroquine-resistant Plasmodium falciparum has been spreading rapidly after its emergence in 1988 in Yekepa. The in vivo and in vitro susceptibilities to quinine and quinidine, compared to chloroquine, were studied by investigating the number of treatment days required for radical cure and estimating the quinine concentrations concomitantly. The minimal inhibitory concentrations (MIC) for schizont maturation in all successful in vitro tests were 5.12 x 10(-6) mol/l for quinine and 1.28 x 10(-6) mol/l for quinidine, indicating that all 50 isolates were sensitive to the two drugs. The IC50 and IC90 values were 0.22 and 0.78 x 10(-6) mol/l for quinine and 0.07 and 0.26 x 10(-6) mol/l for quinidine, respectively. In vitro inhibition of parasites by 1.6 x 10(-6) mol/l of chloroquine was obtained in 31 out of 47 isolates, 16 (34%) being resistant. The IC50, IC90 and geometrical mean MIC for quinine were all about two times higher for the chloroquine-resistant than for the chloroquine-sensitive isolates (P = 0.006). P. falciparum infected children (n = 64) were randomly allocated to four groups and treated with quinine (10 mg/kg body weight twice daily) for 1 day (3 doses), 2, 4 and 7 days, respectively. All cleared their parasitaemias by day 4 but 5 out of 15 of those treated with only three doses showed a recurrence of parasitaemia between days 7 and 14; these were considered to be recrudescences. In the other groups, recurrent parasitaemias only occurred between days 17 and 28 and were considered to be reinfections.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Volunteer experience of an American dietitian in Liberia, West Africa.

An American volunteer dietitian can make significant contributions in a developing country with the support of local personnel. Three objectives were achieved during a recent experience. The first objective was to become familiar with local foods and food customs and to revise the hospital diet manual to reflect Liberian food habits. Clinical observation of malnourished pediatric patients was the second objective, and this led to evaluation of the ELWA Hospital's kwashiorkor formula. The third objective was to provide in-service education to nurses and physicians at the ELWA and JFK Memorial Hospitals in Monrovia. Presentations were made on basic nutrition, diet manual revisions, and a kwashiorkor literature review. These objectives were set at the request of the ELWA Hospital administrator and accomplished with the support of the medical staff.

Diet↗

A serological survey of Lassa fever in Liberia.

A serological survey was undertaken at four Liberian hospitals in 1974 in which serum samples were taken from 104 health workers and 61 patients. Six persons had Lassa fever antibodies: four midwives and two students of midwifery. Of those persons who had lived in Loffa County, 4 of 22 midwives were seropositive whereas none of the other 39 residents were positive (P = 0.014).

Adult↗

Isoenzymes of the lung fluke Paragonimus uterobilateralis from Liberia.

The enzymes of 35 adult Paragonimus uterobilateralis were analysed using thin-layer starch gel electrophoresis. From a total of 21 enzyme systems studied, 15 proved to be useful for the description and recognition of this species. All individuals were identical concerning 11 enzymes. In four remaining enzymes, alanine aminotransferase (ALAT, hexokinase, aspartate aminotransferase and phosphogluconate dehydrogenase, two or three variants, also being partly typical for this species were observed. In a comparison involving seven different enzymes, there were no differences between the electrophoretic patterns of 35 adult and 24 juvenile P. uterobilateralis. Additional examinations of 30 adult P. uterobilateralis with isoelectric focusing on ultrathin-layer polyacrylamide gels revealed clearer separations of enzymes. The method showed corresponding results or identiy of all individuals tested with three representative enzymes (ALAT, glucosephosphate isomerase and adenylate kinase).

Alanine Transaminase↗