Objective and methods: 83 patients infected with P.vivax malaria were divided randomly into two groups. 51 patients were treated with CV8 and 32 patients were treated with Chlo + Pri. Results: The mean time for disolving fever was 20.1 hours for CV8 group and 21.0 hours for Chlo + Pri group, the difference has no statistic significance with P>0.05. The mean parasite clearance time was 30.3 hours and 31.0 hours for CV8 and Chlo + Pri groups. respectively, the difference has no statistic significance with P>0.05. The relapse parasite rate was 3.9 % in CV8 group, highter than that in Chlo + Pri group (3.1%) of , the difference has no statistic significance with P>0.05. Conclusion: CV8 can be used for P. vivax malaria patients in the hyper-epidemic remote areas.
Malaria ; Primaquine ; Malaria ; Falciparum

224 patients with uncomplicated P. falciparum malaria were randomly devided into two groups receiving CV8 treatment (123 patients) and artesunate+primaquine (As+Pri) (101 patients). Results: The lately recurrence rate of CV8 treatment was 3.3% and of As+Pri was 17.8%, the difference had statistic significance (p<0.05). Mean time for fever clearance of CV8 was 22.5 hours, was the same as AS+Pri (21.8 hours). The inhibitory gametocidel effect on CV8 on P.falciparum has been seen and it help elimination of dissermination. The side effects such as nausea (13.8%), vomitting (4.9%) in CV8 treated groups were the same in AS+Pri groups. These effects were often self-limited. There were no hemoglobinuria case.
Malaria, Primaquine, Malaria, Falciparum

We experienced a case of Plasmodium falciparum gametocytemia successfully treated with primaquine in a twenty seven-years old woman. The patient had been admitted due to general malaise after diagosis and treatment of P. falciparum at Tanzania one month ago. On microscopic examination, P. falciparum gametocytemia was seen and treated with mefloquine for one week but gametocytemia was not disappeared. After primaquine treatment for two weeks, she was successfully treated.
Female ; Humans ; Mefloquine ; Plasmodium falciparum* ; Plasmodium* ; Primaquine* ; Tanzania

Plasmodium vivax has many stages in the life cycle, and shows different susceptibilities to anti-malarial drugs at each stage. Of these drugs, primaquine is only drug that has anti-malarial activity to hypnozoite. Generally, primaquine is administered for the prevention of relapse by hypnozoite following the treatment with chloroquine in tertian malaria, at the dosage of 15mg/ day for 14 days. But Plasmodium vivax has different susceptibility to primaquine in different areas (so as to strains), and the resistance to primaquine is increasing in endemic areas. We recently experienced a case of imported tertian malaria that relapsed two times after the completions of chloroquine-primaquine therapy. The patient was treated with 22.5 mg of primaquine for 2 weeks at the first relapse, and 3 weeks course of 30 mg of primaquine in the second relapsing episode. Therefore we report this primaquine-resistant tertian malaria with review.
Chloroquine ; Humans ; Life Cycle Stages ; Malaria* ; Plasmodium vivax ; Primaquine ; Recurrence

Primaquine is often administered for the hypnozoite stage of Plasmodium vivax and Plasmodium ovale. Primaquine (with clindamycin) is also an alternative drug for treatment of pneumocystis pneumonia when trimethoprim/sulfamethoxazole cannot be used. Primaquine may cause methemoglobinemia, an altered state of hemoglobin in which the ferrous state of heme is oxidized to the ferric state. We report a case of methemoglobinemia caused by a standard dose of primaquine plus clindamycin in a 27-year-old female recipient of a kidney transplant who was diagnosed with pneumocystis pneumonia.
Adult ; Clindamycin ; Female ; Heme ; Humans ; Kidney ; Methemoglobin ; Methemoglobinemia* ; Plasmodium ovale ; Plasmodium vivax ; Pneumonia, Pneumocystis ; Primaquine*

Recently, in Korea, imported malarial infections are increased and occasionally domestic infections are reported. But the malarial infected pregnant women are seldom cases and we have experienced second trimester infected one. She had no traveling and transfusion history. She delivered a healthy baby at term by repeated cesarean section and her baby had no evidence of congenital malarial infection. We treated her with hydroxychloroquine at antepartum and primaquine at postpartum. We present this case with a brief review of literatures.
Cesarean Section ; Female ; Humans ; Hydroxychloroquine ; Korea ; Malaria ; Postpartum Period ; Pregnancy Trimester, Second ; Pregnancy* ; Pregnant Women ; Primaquine

OBJECTIVE: Anti-malaria drugs may modulate tumor resistance to chemotherapeutic agents, but it has not been proven effective in the treatment of malignant gliomas. The aim of this study was to determine whether adequate pre-clinical data on co-administration of chemotherapeutic agents with anti-malaria drugs on malignant cell lines could be obtained that would warrant its further potential consideration for use in a clinical trial for malignant gliomas. METHODS: Two malignant glioma cell lines (U87MG, T98G) were treated with chemotherapeutic agents alone or with anti-malaria drugs. Cells were incubated with drugs for 4 days. Following the 4-day incubation, drug sensitivity assays were performed using 3-(4, 5-dimethyl-2-thiazol-2-yl) 2, 5-diphenyltetrazolium bromide (MTT) assay following optimization of experimental conditions for each cell lines and cell viability was calculated. RESULTS: In all of four chemotherapeutic agents(doxorubicin, vincrisitne, nimustine, and cisplatin), the cell viability was found to be markedly decreased when hydroxychloroquine was co-administered on both U87MG and T98G cell lines. The two way analysis of variance(ANOVA) yielded a statistically significant two-sided p-value of 0.0033(doxorubicin), 0.0005(vincrisitne), 0.0007(nimustine), and 0.0003(cisplatin) on U87MG cell lines and 0.0006(doxorubicin), 0.0421(vincrisitne), 0.0317(nimustine), and 0.0001(cisplatin) on T98G cell lines, respectively. However, treatment with chloroquine and primaquine did not induce a decrease in cell viability on both U87MG and T98G cell lines. CONCLUSION: Our data support further consideration of the use of hydroxychloroquine prior to systemic chemotherapy to maximize its tumoricidal effect for patients with malignant gliomas.
Cell Line* ; Cell Survival ; Chloroquine ; Drug Resistance, Multiple ; Drug Therapy ; Glioma* ; Humans ; Hydroxychloroquine* ; Nimustine ; Primaquine

South Korea has been free from endemic malaria by P. vivax since the mid-1980s, but malaria infections, including military outbreak in 1995, have been increasing steadily in the soldiers serving near the western part of Demilitarized Zone(DMZ) since its first resurgence in 1993. We experinced 8 cases of delayed onset P. vivax malaria in young men who had never been abroad and had no history of blood transfusion or parenteral use of drug. All the patients had served near the western part of DMZ during their military life. They were admitted to Yeungnam University hospital due to cyclic fever with chills and the clinical symptoms were developed 2 months to 11months after discharge from military service. Peripheral blood smears showed typical ring forms and trophozoites of P. vivax in red blood cell. Patients were treated with hydroxychloroquine and primaquine showing rapid clinical and hematologic responses in all cases, but 2 cases were relapsed later. We presumed that theses cases were delayed onset of P. vivax infection resulted from the recent outbreak in the western part of DMZ, in 1995. Therefore, we reported theses cases to emphasize the need of active surveillance and prevention.
Blood Transfusion ; Chills ; Erythrocytes ; Fever ; Humans ; Hydroxychloroquine ; Korea ; Malaria ; Malaria, Vivax* ; Male ; Military Personnel ; Primaquine ; Trophozoites

Although it is not certain when malaria began to appear in the Korean peninsula, it is believed to have had been an endemic disease until 1984. Vivax malaria reemerged in the Republic of Korea (ROK) in 1993. In the early period most of the cases occurred among soldiers stationed in the DMZ and the adjacent region. In order to cope with malaria, the soldiers at risk received chemoprophylaxis with chloroquine and primaquine. The regimen for the treatment of vivax malaria in Korea was established in 1950's. Primaquine was introduced in 1951, and the field testing during the Korean War demonstrated that the combination of three days of chloroquine administration with fourteen days of primaquine reliably prevented the recurrence of vivax malaria. The regimen has been used since then, but there were some controversies as to whether or not to start chloroquine and primaquine on the same day. Most of the current treatment guidelines recommend the use of primaquine for fourteen days to overlap with blood schizonticide agents such as chloroquine and routine tests for G-6-PD deficiency before use. Previous data showed that the G-6-PD deficiency rate has been found very low among Koreans. Thus, it is not always necessarily mandatory to test for G-6-PD deficiency among Korean patients.
Chemoprevention ; Chloroquine ; Endemic Diseases ; Glucosephosphate Dehydrogenase ; Humans ; Korea* ; Korean War ; Malaria ; Malaria, Vivax* ; Military Personnel ; Primaquine ; Recurrence ; Republic of Korea

Vaccination against yellow fever is recommended for travelers to areas where yellow fever has been reported, and they should be vaccinated 10 days before the travel at an approved center for the vaccination. When traveling to areas where chloroquine-resistant P. falciparum has not been reported, once-a-week use of chloroquine alone is recommended, but when traveling to areas where chloroquineresistant P. falciparum has been reported, other agents such as mefloquine, doxycycline, atovaquone/proguanil and primaquine should be chosen. Other recommended immunizations are typhoid vaccine and hepatitis A/B vaccine. Traveler's diarrhea is one of the major health problems in terms of frequency, but antimicrobial prophylaxis is not routinely recommended.
Chloroquine ; Communicable Diseases* ; Diarrhea ; Doxycycline ; Hepatitis ; Immunization ; Malaria ; Mefloquine ; Primaquine ; Travel Medicine ; Typhoid-Paratyphoid Vaccines ; Vaccination ; Yellow Fever