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  • Title: [Therapy and prevention of malaria].
    Author: Bianchini C.
    Journal: Medicina (Firenze); 1989; 9(1):27-40. PubMed ID: 2661957.
    Abstract:
    Malaria is still, in spite of intensive efforts to reduce its transmission, the most serious and widespread protozoal infection in man. More than 100 million people suffer of malaria each year and one million, mostly children, die for it. Widespread resistance of P. falciparum to drugs, especially 4-aminoquinoline, has been progressing to such a speed in many endemic malarious areas that therapy and prophylaxis procedures have been changing and new drugs or associations of them have been introduced. Quinine and chloroquine are still the main therapeutic agents against the blood forms of plasmodia, and quinine is the first choice drug in severe and complicated malaria. Mefloquine is highly effective against multiresistant P. falciparum, but it is not yet available in Italy. Association of sulfadoxine or sulfamethoxypyrazine to pyrimethamine can be used for therapy of resistant P. falciparum malaria, but resistance to it is quickly spreading and side effects can be very dangerous. Chemoprophylaxis must be weighed against the risk of toxic effects. Chloroquine is still the drug of choice; tetracyclines can be added, for short periods, in areas of chloroquine resistant malaria and mefloquine could be used in selected group of people, at high risk of infection. For long time protection against malaria infection it is most important to rely on protective measures against mosquito bites: screens, mosquito nets, pyrethroids insecticides, skin repellents and wearing protective clothes. The role of malaria vaccines can be very important in the prevention, but many practical problems have to be solved in order to achieve a wide use of the various preparations actually under trials.
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