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. 1988;66(4):477–484.

A quantitative approach to recommendations on malaria prophylaxis

M Pappaioanou, H O Lobel, C C Campbell
PMCID: PMC2491167  PMID: 3048761

Abstract

In order to develop recommendations for malaria prophylaxis, a quantitative method is needed to balance the risk of Plasmodium falciparum malaria infections against the toxicity of antimalarial drugs. Using decision analysis, we estimated the expected mortality associated with three alternative regimens of prophylactic drugs for visitors to three areas with different risks of infection with chloroquine-resistant P. falciparum. The model used took into account the risks of malaria and of adverse reactions to antimalarial drugs. Estimates of the parameters used in the analysis were based on observations made on U.S. travellers. Reducing the risk of malaria infection was found to have a far greater impact on lowering the expected mortality than that of increasing the chemoprophylactic efficacy of the drugs used, thereby emphasizing the need for travellers to use anti-mosquito measures in malarious areas. The analytical method described can be used to define optimal malaria prevention strategies.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bruce-Chwatt L. J., Hutchinson D. B. Maloprim and agranulocytosis. Lancet. 1983 Dec 24;2(8365-66):1487–1488. doi: 10.1016/s0140-6736(83)90825-5. [DOI] [PubMed] [Google Scholar]
  2. Centers for Disease Control (CDC) Revised recommendations for preventing malaria in travelers to areas with chloroquine-resistant Plasmodium falciparum. MMWR Morb Mortal Wkly Rep. 1985 Apr 12;34(14):185-90, 195. [PubMed] [Google Scholar]
  3. Hatton C. S., Peto T. E., Bunch C., Pasvol G., Russell S. J., Singer C. R., Edwards G., Winstanley P. Frequency of severe neutropenia associated with amodiaquine prophylaxis against malaria. Lancet. 1986 Feb 22;1(8478):411–414. doi: 10.1016/s0140-6736(86)92371-8. [DOI] [PubMed] [Google Scholar]
  4. Khoromana C. O., Campbell C. C., Wirima J. J., Heymann D. L. In vivo efficacy of chloroquine treatment for Plasmodium falciparum in Malawian children under five years of age. Am J Trop Med Hyg. 1986 May;35(3):465–471. doi: 10.4269/ajtmh.1986.35.465. [DOI] [PubMed] [Google Scholar]
  5. Le Bras J., Hatin I., Bouree P., Coco-Cianci O., Garin J. P., Rey M., Charmot G., Roue R. Chloroquine-resistant falciparum malaria in Benin. Lancet. 1986 Nov 1;2(8514):1043–1044. doi: 10.1016/s0140-6736(86)92657-7. [DOI] [PubMed] [Google Scholar]
  6. Lobel H. O., Campbell C. C., Pappaioanou M., Huong A. Y. Use of prophylaxis for malaria by American travelers to Africa and Haiti. JAMA. 1987 May 15;257(19):2626–2627. [PubMed] [Google Scholar]
  7. Lobel H. O., Campbell C. C., Roberts J. M. Fatal malaria in US civilians. Lancet. 1985 Apr 13;1(8433):873–873. doi: 10.1016/s0140-6736(85)92232-9. [DOI] [PubMed] [Google Scholar]
  8. Lobel H. O., Campbell C. C., Schwartz I. K., Roberts J. M. Recent trends in the importation of malaria caused by Plasmodium falciparum into the United States from Africa. J Infect Dis. 1985 Sep;152(3):613–617. doi: 10.1093/infdis/152.3.613. [DOI] [PubMed] [Google Scholar]
  9. Lobel H. O., Roberts J. M., Somaini B., Steffen R. Efficacy of malaria prophylaxis in American and Swiss travelers to Kenya. J Infect Dis. 1987 Jun;155(6):1205–1209. doi: 10.1093/infdis/155.6.1205. [DOI] [PubMed] [Google Scholar]
  10. Miller K. D., Lobel H. O., Satriale R. F., Kuritsky J. N., Stern R., Campbell C. C. Severe cutaneous reactions among American travelers using pyrimethamine-sulfadoxine (Fansidar) for malaria prophylaxis. Am J Trop Med Hyg. 1986 May;35(3):451–458. doi: 10.4269/ajtmh.1986.35.451. [DOI] [PubMed] [Google Scholar]
  11. Neftel K. A., Woodtly W., Schmid M., Frick P. G., Fehr J. Amodiaquine induced agranulocytosis and liver damage. Br Med J (Clin Res Ed) 1986 Mar 15;292(6522):721–723. doi: 10.1136/bmj.292.6522.721. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Pauker S. G., Kassirer J. P. Decision analysis. N Engl J Med. 1987 Jan 29;316(5):250–258. doi: 10.1056/NEJM198701293160505. [DOI] [PubMed] [Google Scholar]
  13. Peto T. E., Gilks C. F. Strategies for the prevention of malaria in travellers: comparison of drug regimens by means of risk-benefit analysis. Lancet. 1986 May 31;1(8492):1256–1261. doi: 10.1016/s0140-6736(86)91395-4. [DOI] [PubMed] [Google Scholar]
  14. Spencer H. C. Drug-resistant malaria--changing patterns mean difficult decisions. Trans R Soc Trop Med Hyg. 1985;79(6):748–758. doi: 10.1016/0035-9203(85)90108-7. [DOI] [PubMed] [Google Scholar]

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