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Biomedical subjects

M B Denis

Publications and source records attributed to M B Denis.

6 recordsLinked to original sources
PubMed1998

Improving compliance with quinine + tetracycline for treatment of malaria: evaluation of health education interventions in Cambodian villages.

To improve compliance with a 7-day quinine + tetracycline regimen against malaria, two health education interventions were tested on populations in two separate groups of villages. In one group, the use of posters and video improved the compliance rates from 0.5% to 20% (20% effectiveness; 95% confidence interval (CI), 13-26%); in the other, where posters alone were used, full compliance changed from 6% to 11% (6% effectiveness; 95% CI, 0-12%). The improved compliance in the first group occurred mainly among those who went to health practitioners (effectiveness 40%) rather than drug vendors (effectiveness 2%), although this could not be attributed to differences in the advice they gave to patients. After the poster plus video intervention, more patients bought quinine + tetracycline and received correct advice encouraging the use of a full course; however, not all of them actually completed the full course by self-administration.

Adult↗
PubMed1992

Malaria in Cambodia.

There are around half a million cases of malaria with 5-10,000 deaths per year in Cambodia. Incidence rates vary in different parts of the country. Malaria control is hampered by multiple drug resistance of Plasmodium falciparum, inaccessibility to the major vector, poor security in most malarious areas, and lack of resources. The control strategy emphasises improvement of clinical management and provision of prompt and accurate diagnosis in order to reduce morbidity and to prevent mortality. In addition health information and drug distribution systems are being improved. The use of pyrethroid-treated mosquito nets and health education are being promoted. Particular attention is given to returning refugees as they settle into the country.

Antimalarials↗
PubMed1988

Response of Kampuchean strains of Plasmodium falciparum to antimalarials: in-vivo assessment of quinine and quinine plus tetracycline; multiple drug resistance in vitro.

Forty-three patients were enlisted in the in-vivo test for sensitivity of Kampuchean strains of Plasmodium falciparum to quinine. The mean parasite density count on day 0 was 32,398 asexual parasites per microliter of blood. With a dosage of 1.5 g quinine base daily for 10 days the average parasite clearance time was 5.6 days, and the average duration of fever 3.4 days. The in-vivo test was evaluated at 7 and 10 days after the start of therapy. After 7 days only 16 patients were parasite negative by microscopic examination (S); 20 patients had an RI recrudescence, four patients responded at the RII level and three at the RIII level. Evaluating the in-vivo test at 10 days, the number of patients parasite negative increased to 18, the number of those with an RI level of resistance increased to 21, two patients gave an RII response and two had an RIII level of resistance. Twenty-two adult males were included in an in-vivo test of the sensitivity of P. falciparum to quinine plus tetracycline. The course of treatment was: quinine 3 x 500 mg daily for 10 days, tetracycline 3 x 500 mg for 7 days. Parasite density counts on day 0 averaged 11,393 asexual parasites per microliter of blood. The average parasite clearance time was 5.9 days, and the average duration of fever was 3.8 days. After 7 days of treatment, 81.8% of patients were parasite negative, while one patient had a recrudescence after 17 days (RI). Three infections were resistant at the RII level. By prolongation of the observations to day 10, the parasitaemia was cleared in all patients, i.e. all infections were sensitive to quinine plus tetracycline. Thirty-four patients with falciparum malaria were screened for in-vitro resistance to chloroquine, mefloquine and quinine using the WHO standard micro-test.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1986

[Preliminary study, in vitro, of the sensitivity of P. falciparum to chloroquine, mefloquine and quinine during 1985, in Kampuchea].

In vitro sensitivity studies of three antimalarials against 45 strains of P. falciparum isolated in western and north-western provinces of Kampuchea, has been carried out, following the WHO microtest. The results, derived from 15 strains, exhibit a resistance rate of 12/14 with chloroquine, 6/6 with quinine and 0/14 with mefloquine. These results, compared with past and current in vivo studies, confirm that the chloroquine therapy should not anymore employed. Quinine remains efficient, but the parasitemia decrease is slow and this treatment must be often carried out for 14 days and renewed in 6% of the cases. Mefloquine was quite efficient on 21 patients followed for 28 days. While waiting for mefloquine availability, studies are carried out for in vivo and in vitro appraisal of the chemosensitivity condition of P. falciparum strains isolated from other endemic areas of Kampuchea in order to determine the most satisfying antimalarial association as far as cost/effectiveness ratio is concerned.

Adult↗