Nova proposta de tratamento para malária por Plasmodium vivax
Relapses that may occur with long standard treatment of vivax malaria might be in part due to an incomplete patient compliance. Therefore, the employment of short treatment schemes leading to a better patient compliance, and the same time having efficacy, tolerance and minimal or none adverse rea...
| Autor principal: | ABDON, Nagib Ponteira |
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| Grau: | Dissertação |
| Idioma: | por |
| Publicado em: |
Universidade Federal do Pará
2013
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http://repositorio.ufpa.br/jspui/handle/2011/3567 |
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ir-2011-35672019-05-21T15:31:25Z Nova proposta de tratamento para malária por Plasmodium vivax ABDON, Nagib Ponteira SOUZA, José Maria de http://lattes.cnpq.br/6459204248879587 Malária vivax Plasmodium vivax Diagnóstico laboratorial Terapêutica Belém - PA Pará - Estado Amazônia brasileira CNPQ::CIENCIAS DA SAUDE::MEDICINA::CLINICA MEDICA::DOENCAS INFECCIOSAS E PARASITARIAS Relapses that may occur with long standard treatment of vivax malaria might be in part due to an incomplete patient compliance. Therefore, the employment of short treatment schemes leading to a better patient compliance, and the same time having efficacy, tolerance and minimal or none adverse reactions is a matter of serious concern. In order to attain this objective, between july, 1994 to june, 1995, an open, comparative, prospective and randomized study was made in the attendance outpatient unit of Malaria Program of Evandro Chagas Institute, in Belem, Para State. Just patients aged up 12 years, from both sexes, which stayed in Belem during all the period control were enrolled. All patients were from Amazon Region, being the great majority of them from Para (85.8%). Autochthonous cases from the metropolitan area of Belem represented 39.2% of the sample. In this study, 120 patients were divided into 3 groups of 40 patients according to the following therapeutic schemes : Scheme I - chloroquine phosphate tablets with 150 mg of base substance in a total dose of 25 mg / kg / day for 3 days, that is, 10 mg / kg / day in the first day, 7.5 mg / kg / day in the second and third day, plus primaquine phosphate tablets with 15 mg of base substance in a dose of 0.25 mg / kg / day for 14 days. Scheme II - chloroquine phosphate tablets with 150 mg of base substance, 10 mg / kg in a single dose plus primaquine phosphate tablets with 15 mg of base substance in a dose of 0.50 mg / kg / day for 7 days. Scheme III - chloroquine phosphate tablets with 150 mg of base substance, 10 mg / kg in a single dose plus primaquine phosphate tablets with 15 mg of base substance in a dose of 0.50 mg / kg/ day for 5 days. Drugs were administered orally, under medical supervision to all outpatients.Clinical diagnosis was based upon history, epidemiology and physical examination of patients, while the laboratory finding of the hematozoa plasmodium in a thick blood film established the definitive malaria diagnosis. All 3 therapeutic schemes were effective, with a cure rate up to 80%. In the II therapeutic scheme, relapses were not observed. The disappearance of malarial symptoms occurred until 96 hours of treatment, while the assexual parasitaemie clearance occurred until 72 hours, considering all 3 therapeutic schemes. When present, adverse reactions were observed in a short period of time. Even in the cases of primaquine in double dose, there were no toxicity. Recaídas que podem ocorrer com o tratamento convencional de longa duração para malária por P. vivax e são em parte devido a parcial adesão do paciente. Portanto a utilização de esquemas terapêuticos de curta duração é capaz de proporcionar melhor acompanhamento do caso e ao mesmo tempo manter a eficácia, ser de boa tolerância e praticamente isento de efeitos adversos. O presente trabalho foi desenvolvido no Programa de Malária do Instituto Evandro Chagas, em Belém do Pará, no período de julho de 1994 a junho de 1995. O estudo caracterizou-se por ser aberto, comparativo, prospectivo e randomizado. Participaram aqueles com idade superior a 12 anos, de ambos os sexos e que pudessem permanecer em Belém até o final do controle. Todos procederam da Amazônia, sendo que o Pará foi o responsável pela maioria dos casos (85,8%) e a área metropolitana de Belém contribuiu com 39,2%, equivalente a autoctonia. A amostra foi composta de 120 pacientes, os quais foram alocados em 3 diferentes esquemas, cada um com 40 participantes, conforme a seguinte distribuição: esquema I - fosfato de cloroquina, comprimidos contendo 150 mg de substância base - 25 mg / Kg como dose total, dividida em 3 dias, sendo 10 mg / Kg de peso corporal no primeiro dia; 7,5 mg / Kg no segundo e terceiro dias, associada ao fosfato de primaquina, comprimidos contendo 15 mg de substância base - 0,25 mg / Kg / dia, por 14 dias; esquema II - fosfato de cloroquina, comprimido contendo 150 mg de substância base - 10 mg / Kg, dose única, associada ao fosfato de primaquina comprimidos contendo 15 mg de substância base - 0,50 mg / KG / dia, por 7 dias; esquema III - fosfato de cloroquina, comprimidos contendo 150 mg de substância base - 10 mg / Kg, dose única, associada ao fosfato de primaquina comprimidos contendo 15 mg de substância base - 0,50 mg / Kg / dia, por 5 dias. A medicação foi administrada por via oral, sob supervisão médica, sendo todos os pacientes tratados em regime ambulatorial. O diagnóstico clínico fundamentou-se na história, epidemiologia e exame físico do paciente, enquanto o encontro do hematozoário, plasmódio, através da gota espessa, confirmou o caso de malária. As respostas terapêuticas aos 3 esquemas foram satisfatórias, com percentual de cura acima dos 80%, sendo que o esquema II, não permitiu recaídas. O desaparecimento da tríade sintomática ocorreu no máximo em até 96 horas, e a negativação da parasitemia assexuada em até 72 horas, para os três diferentes esquemas de tratamento. Os efeitos colaterais foram mínimos e efêmeros. Não se observou toxicidade, mesmo com doses duplicadas de primaquina. 2013-03-18T14:30:45Z 2013-03-18T14:30:45Z 1997 Dissertação ABDON, Nagib Ponteira. Nova proposta de tratamento para malária por Plasmodium vivax. 1997. 93 f. Dissertação (Mestrado) - Universidade Federal do Pará, Núcleo de Medicina Tropical, Instituto Evandro Chagas, Belém, 1997. Curso de Pós-Graduação em Medicina Tropical. http://repositorio.ufpa.br/jspui/handle/2011/3567 por Acesso Aberto application/pdf Universidade Federal do Pará Instituto Evandro Chagas Brasil Núcleo de Medicina Tropical UFPA IEC Programa de Pós-Graduação em Doenças Tropicais |
| institution |
Repositório Institucional - Universidade Federal do Pará |
| collection |
RI-UFPA |
| language |
por |
| topic |
Malária vivax Plasmodium vivax Diagnóstico laboratorial Terapêutica Belém - PA Pará - Estado Amazônia brasileira CNPQ::CIENCIAS DA SAUDE::MEDICINA::CLINICA MEDICA::DOENCAS INFECCIOSAS E PARASITARIAS |
| spellingShingle |
Malária vivax Plasmodium vivax Diagnóstico laboratorial Terapêutica Belém - PA Pará - Estado Amazônia brasileira CNPQ::CIENCIAS DA SAUDE::MEDICINA::CLINICA MEDICA::DOENCAS INFECCIOSAS E PARASITARIAS ABDON, Nagib Ponteira Nova proposta de tratamento para malária por Plasmodium vivax |
| topic_facet |
Malária vivax Plasmodium vivax Diagnóstico laboratorial Terapêutica Belém - PA Pará - Estado Amazônia brasileira CNPQ::CIENCIAS DA SAUDE::MEDICINA::CLINICA MEDICA::DOENCAS INFECCIOSAS E PARASITARIAS |
| description |
Relapses that may occur with long standard treatment of vivax malaria might be in
part due to an incomplete patient compliance. Therefore, the employment of short
treatment schemes leading to a better patient compliance, and the same time having
efficacy, tolerance and minimal or none adverse reactions is a matter of serious
concern. In order to attain this objective, between july, 1994 to june, 1995, an open,
comparative, prospective and randomized study was made in the attendance
outpatient unit of Malaria Program of Evandro Chagas Institute, in Belem, Para
State. Just patients aged up 12 years, from both sexes, which stayed in Belem
during all the period control were enrolled. All patients were from Amazon Region,
being the great majority of them from Para (85.8%). Autochthonous cases from the
metropolitan area of Belem represented 39.2% of the sample. In this study, 120
patients were divided into 3 groups of 40 patients according to the following
therapeutic schemes : Scheme I - chloroquine phosphate tablets with 150 mg of
base substance in a total dose of 25 mg / kg / day for 3 days, that is, 10 mg / kg / day
in the first day, 7.5 mg / kg / day in the second and third day, plus primaquine
phosphate tablets with 15 mg of base substance in a dose of 0.25 mg / kg / day for
14 days. Scheme II - chloroquine phosphate tablets with 150 mg of base substance,
10 mg / kg in a single dose plus primaquine phosphate tablets with 15 mg of base
substance in a dose of 0.50 mg / kg / day for 7 days. Scheme III - chloroquine
phosphate tablets with 150 mg of base substance, 10 mg / kg in a single dose plus
primaquine phosphate tablets with 15 mg of base substance in a dose of 0.50 mg /
kg/ day for 5 days. Drugs were administered orally, under medical supervision to all
outpatients.Clinical diagnosis was based upon history, epidemiology and physical
examination of patients, while the laboratory finding of the hematozoa plasmodium in
a thick blood film established the definitive malaria diagnosis. All 3 therapeutic
schemes were effective, with a cure rate up to 80%. In the II therapeutic scheme,
relapses were not observed. The disappearance of malarial symptoms occurred until
96 hours of treatment, while the assexual parasitaemie clearance occurred until 72
hours, considering all 3 therapeutic schemes. When present, adverse reactions were
observed in a short period of time. Even in the cases of primaquine in double dose,
there were no toxicity. |
| author_additional |
SOUZA, José Maria de |
| author_additionalStr |
SOUZA, José Maria de |
| format |
Dissertação |
| author |
ABDON, Nagib Ponteira |
| title |
Nova proposta de tratamento para malária por Plasmodium vivax |
| title_short |
Nova proposta de tratamento para malária por Plasmodium vivax |
| title_full |
Nova proposta de tratamento para malária por Plasmodium vivax |
| title_fullStr |
Nova proposta de tratamento para malária por Plasmodium vivax |
| title_full_unstemmed |
Nova proposta de tratamento para malária por Plasmodium vivax |
| title_sort |
nova proposta de tratamento para malária por plasmodium vivax |
| publisher |
Universidade Federal do Pará |
| publishDate |
2013 |
| url |
http://repositorio.ufpa.br/jspui/handle/2011/3567 |
| _version_ |
1787149279703334912 |
| score |
11.675608 |