Short communication: concomitant malaria and filariasis infections in Georgetown, Guyana

Lymphatic filariasis and malaria are endemic in Guyana, South America. To determine the prevalence of concomitant infections, we conducted a 1-year survey of febrile patients attending the malaria (day) and filariasis (night) clinics in Georgetown. In all, 1278 thick blood smears were collected; 769 for filariasis, of which 103 were positive for Wucheria bancrofti, and three for both W. bancrofti and malaria parasites; and 509 for malaria, 21 of which tested positive for malaria and 17 for both malaria and filariasis. The age groups and sex of the infected persons with malaria and W. bancrofti are descibed. These results suggest that the incidence of concomitant infections in Guyana may be quite low but efforts should be made to reduce the disease burden in Georgetown, Guyana (AU)

Increase of malaria among migrants in Amsterdam-Zuidoost

In a general practice in Amsterdam SouthEast in 1998 a delayed first attack of Plasmodium ovale infection was diagnosed in a 13-year-old-girl from Ghana, malaria tropica with a low parasitaemia index in a 43-year-old Ghanaian man and a 8-year-old Ghanaian girl, and a Plasmodium vivax infection in a 44-year-old Surinam woman. The Ghanaian patients had visited their native country, the Surinam woman had contracted the infection during a visit to India. All patients responded well to antimalaria medication. These patients were among a total of 6 patients of non-Dutch origin diagnosed with malaria in 1998 in this general practice. Four patients had not taken any prophylactic drug and two had not used the drugs properly. A relative increase of malaria in immigrants has been seen in the Netherlands and elsewhere in Europe in recent years. Underestimation of the risks and lack of knowledge of malaria and of the changing epidemiology make people of ethnic minorities travel without taking appropriate precautions. New, creative ways of communication and information will have to be explored to reach these migrant communities. (AU)

Failure of combined choroquine and high-dose primaquine therapy for Plasmodium vivax malaria acquired in Guyana, South America

The presence of chloroquine-resistant Plasmodium vivax malaria in the New World has been suspected but not confirmed. We report the cases of three patients who acquired vivax malaria in Guyana, South America, and for whom standard chloroquine therapy (25mg/kg) failed despite therapeutic blood levels. The optimal treatment of Chloroquine-resistant P. vivax malaria is unknown, but recent studies suggest that a combination of chloroquine (25 mg/kg) and high-dose primaquine (2.5 mg/kg over 48 hours) is effective therapy. Two of our patients had recurrences of P. vivax malaria 6-8 weeks after receiving directly observed therapy with this combination. These cases confirm the presence of chloroquine-resistant P. vivax in Guyana and emphasize the need for better treatment regimens for chloroquine-resistant and primaquine-resistant P. vivax malaria.(AU)

A case of vivax malaria presenting with psyhosis

The first case of psychosis due to Plasmodium vivax malaria, imported from India is reported. A 44-year-old Trinidadian male presented with fever, and psychotic episodes in association with vivax malaria. The symptoms of both malaria and psychosis were resolved following the standard chloroquine-primaquine therapy (AU)

A case of Vivax Malaria presenting with psychosis

The first case of psychosis due to Plasmodium vivax malaria, imported from India is reported. A 44-year-old Trinidadian male presented with fever, and psychotic episodes in association with vivax malaria. The symptoms of both malaria and psychosis were resolved following the standard chloroquine-primaquine therapy (AU)

Highly prevalent falciparum malaria in North West Guyana: Its development history and control problems

After being absent from North West Guyana for over two decades, falciparum malaria returned in force in 1986 and soon developed a high prevalence affecting a large share of the region's inhabitants. This falciparum upsurge was accompanied by a significant rise in the number of vivax cases that helped bring the annual parasite index to figures ranging from 260 positive smears per 1000 inhabitants in 1986 to 973 in 1988 and 776 in 1991. The chloroquine-resistant P. falciparum strain responsible, apparently travelled from the area of the Rupununi River in Southern Guyana to the more northern Cuyuni/Mazaruni Potaro area in 1985, and from there was brought into the North West Region, probably by itinerant miners. Circumstances leading to the present endemic demonstrate how transient populations, resistant parasites, and economic restraints can interfere with malaria control, and how rapidly high malaria prevalences can establish themselves in receptive tropical areas vulnerable to attack (AU)

An epidemic outbreak of plasmodium vivax malaria in Trinidad - abstract

An outbreak of Plasmodium vivax malaria occurred in Trinidad some 25 years after a successful eradication programme. The "index case" was infected while visiting Perdanales, Venezuela, and was responsible for the renewal of malaria transmission by indigenous Anopheles aquasalis mosquitoes in Icacos, Trinidad, West Indies. In Icacos, nine cases (4 females and 5 males) of P. vivax malaria were locally transmitted. The largest age-groups contracting malaria were 15 - 24 and 25 - 44 years, together constituting 70 per cent of all cases. However, in Granville/Chatham another unrelated case of locally transmitted P. vivax malaria was discovered through active surveillance. The intervention measures adopted which successfully eradicated P. vivax malaria from Trinidad included hospital treatment of all infected cases, prophylactic chloroquine, (300 mg weekly) to all adult visitors and vector control workers, cyclical residual spraying of houses in Icacos and surrounding townships and weekly spraying with malaroil of nearby swamps and low-lying areas. The need to maintain malaria surveillance is also emphasised (AU)