RESUMO
Combination therapy is one method of overcoming the global challenge of drug-resistant Plasmodium falciparum malaria. We conducted a hospital-based 28-day in vivo test comparing chloroquine/doxycycline to chloroquine or doxycycline alone for treating P. falciparum and Plasmodium vivax malaria in Irian Jaya, Indonesia. Eighty-nine patients with uncomplicated falciparum malaria were randomized to standard dose chloroquine (n = 30), doxycycline (100 mg every 12 hours [7 days], n = 20), or chloroquine with doxycycline (n = 39); corresponding numbers for vivax malaria (n = 63) were 23, 16, 24. Endpoints were parasite sensitivity (S) or resistance (RI/RII/RIII). Of the 105 evaluable patients, chloroquine/doxycycline cured (S) 20/22 (90.9% [95% CI 78.9-100%]) patients with P. falciparum malaria; 2/22 (9.1% [0-21%]) were RIII resistant. Doxycycline cured 11/17 (64.7% [42.0-87.4%]) patients, and chloroquine 4/20 (20% [2.5-37.5%]). Against P. vivax, chloroquine/doxycycline cured (S) 12/17 (70.6% [48.9-92.2%]) patients, doxycycline 4/12 (33.3% [6.6-59.9%]), and chloroquine 5/17 (29.4% [7.7-51.1%]). Chloroquine/doxycycline was effective against P. falciparum but only modestly effective against P. vivax. These findings support the use of chloroquine/doxycycline as an inexpensive alternative to mefloquine for treating chloroquine-resistant P. falciparum but not chloroquine-resistant P. vivax in this setting.
Assuntos
Antimaláricos/uso terapêutico , Cloroquina/uso terapêutico , Doxiciclina/uso terapêutico , Malária/tratamento farmacológico , Plasmodium falciparum/isolamento & purificação , Plasmodium vivax/isolamento & purificação , Adulto , Animais , Antimaláricos/administração & dosagem , Antimaláricos/sangue , Cloroquina/administração & dosagem , Cloroquina/sangue , Doxiciclina/administração & dosagem , Quimioterapia Combinada , Feminino , Humanos , Indonésia , Malária/parasitologia , Masculino , Resultado do TratamentoRESUMO
In a 10-year period (1970-1979) 6,111 cancer cases in males and 7,646 cases (55.3%) in females were registered. The female genital tract cancers occurred in 23.8% of all malignancies in the female. The relative frequency of the gynecological tumors was: cervix 60.3%, ovarium 25.5%, corpus uteri 6.9%, chorioca 5.1% and vulva/vagina 2.2%. A comparison is made with former reports and with other places in Indonesia.
