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Original Articles
Clinical Observation in 14 Cases of Chloroquine-Resistant Imported Malaria
Sang Do Lee, Jae Hong Lee, Sung Min Noh, Il Doo Lee, Byeung Yeub Park, Ju Sup Jung
Department of Internal Medicine, Hae Dong Hospital
Vol.26 Num.4 (p309~315)
Recently the prevalence of
malaria and chloroquine-resistant malaria has been increasing around the world and there is an increasing concern about exogenous malaria in non-endemic areas.
We reported 14 cases of chloroquine-resistant imported malaria seen at the Hae Dong Hospital from 1992 to May 1994 with a review of the literatures.
The following is a summary of the findings.
1) All cases were physically active men with a mean age of 38.6 years and were infected with chloroquine-resistant species.
2) The 11cases were Plasmodium falciparum infection and the other cases were undetermined.
3) The majority(93%) of patients had malaria imported from Africa.
4) All patients had fever, chill, generalized malaise.
Gastrointestinal symptoms and hepatosplenomegaly were developed in 50% of patients.
5) About 20% of the patients had serious complications such as hemolytic anemia, acute renal failure and jaundice.
6) In the 3cases of severe malaria,intravenous quinine therapy was attempted and treated successfully. The other cases of chloroquine-resistant malaria were treated with quinine plus tetracycline combination therapy and Fansidar.
In the cases, which can not be tolerable because of side effects and resist to above therapy, therapy was substituted to halofantrine.
7) Halofantrine is effective against chloroquine-resistant malaria and recommended the alternative therapy of multidrug resistant malaria.
Keywords : Malaria, Chloroquine-resistant species, Halofantrine