About 10 per cent. of troops involved in jungle operations along the Thai-Malayan border in North Perlis during August to October, 1962, developed malaria in spite of proguanil prophylaxis. The majority of these had Plasmodium falciparum infections, many of which relapsed after larger than usual dosages of chloroquine. Ten of the cases were studied in more or less detail, and clinical evidence of chloroquine as well as proguanil resistance was obtained. In two cases, laboratory confirmation of the clinical evidence was obtained as relapse occurred in the presence of plasma chloroquine levels generally considered
MeSH terms: Animals; Proguanil*; Chloroquine*; Drug Resistance*; Drug Resistance, Microbial*; Humans; Malaria*; Malaysia; Culicidae*; Plasmodium falciparum*; Malaria, Falciparum*
1) Five strains of P. falciparum suspected of being chloroquine resistant were established in eight prisoner volunteers. Two of these strains originated from Cambodia and are referred to as Cambodian I and II. Three are from natural infections in Malaya and are referred to as Malayan I, II and III.
2) These strains were studied for their response to one to five anti-malarial drugs; namely, chloroquine, proguanil, mepacrine, pyrimethamine and quinine.
3) The Cambodian I strain was susceptible to chloroquine when the 1.5 gramme regimen of the base was given.
4) The Cambodian II and the Malayan II strains were resistant to chloroquine, proguanil, mepacrine and pyrimethamine but susceptible to quinine.
5) The Malayan I strain was resistant to chloroquine and to proguanil but susceptible to pyrimethamine and to quinine.
6) The Malayan III strain was resistant to chloroquine, proguanil and pyrimethamine but susceptible to mepacrine and to quinine.
7) Quinine was the only anti-malarial to which all strains were susceptible. A comparison between these strains and the chloroquine resistant strains from Colombia and Thailand is presented.
In Northern Malaya conditions are exceptionally favourable for studying human victims of the pit viper Ancistrodon rhodostoma (Boie). The results of a double-blind controlled therapeutic trial in moderate poisoning following bites of this snake are described.
The purpose of the trial was to see if specific antivenene given within six hours of the bite and prednisone started within six hours of the bite produced better results than control treatment.
The trial was carried out at Sungei Patani Hospital: 105 patients aged 10 to 69 years inclusive were admitted to the trial, but subsequently five subjects were withdrawn. Patients were allocated at random to one of three treatment schedules: (1) specific antivenene 50 ml. with 1 ml. of hyaluronidase by intramuscular injections, dummy tablets; (2) distilled water 50 ml. with 1 ml. of hyaluronidase by intramuscular injection, prednisone tablets totalling
120 mg. within three days of the bite; and (3) distilled
water 50 ml. with I ml. of hyaluronidase by intramuscular injection, dummy tablets. Statistical analysis shows that the difference between
incidence and severity of systemic poisoning in the antivenene group and in the groups receiving prednisone or control treatment was highly significant. In contrast, there was no statistically significant difference between the clinical features of local poisoning in these three groups. Thus specific antivenene is very effective in combating systemic poisoning following bites of the pit viper A. rhodostoma but does not appear to help local poisoning. Prednisone seems to benefit neither systemic nor local poisoning.