Browsing by Author "Utz, G."
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Item Mefloquine (MQ) single dose 20 mg/kg treatment of falciparum malaria was evaluated in 186 children of 6-24 months of age in northern Ghana(American Journal of Tropical Medicine and Hygiene 76(2): 224-31, 2007) Fryauff, D.J.; Owusu-Agyei, S.; Utz, G.; Baird, J.K.; Koram, K.A.; Binka, F.; Nkrumah, F.; Hoffman, S.L.There were 15 RII/RIII-type parasitologic failures, all with Day 2 MQ blood levels significantly lower than children whose parasitemias cleared before Day 7 and remained clear through 28 days. Predictors of RII/RIII parasitologic response were vomiting after MQ dosing, Day 2 MQ levels < 500 ng/mL, and undetectable Day 2 levels of the carboxymefloquine metabolite. There were 50 cases of delayed RI parasitologic failure, but 71% of these cases had undetectable Day 28 blood levels of MQ and drug levels in the remaining 29% ranged below the 620 ng/mL level that suppresses MQ sensitive strains of P. falciparum. Drug levels among infants that tolerated MQ well were not associated with age, weight, hemoglobin, parasitemia, and pre-existing symptoms of vomiting or diarrhea. An observed recurrent parasitemia of 34,400 trophozoites/microL against a MQ blood concentration of 550 ng/mL was taken as indication of tolerance to suppressive levels of the drug at this location.Item Mefloquine treatment for uncomplicated falciparum malaria in young children 6-24 months of age in northern Ghana.(2007-02) Fryauff, D. J.,; Owusu-Agyei, S.; Utz, G.; Baird, J. K; Koram, K.A.; Binka, F.; Nkrumah, F.; Hoffman, S. L.Mefloquine (MQ) single dose 20 mg/kg treatment of falciparum malaria was evaluated in 186 children of 6-24 months of age in northern Ghana. There were 15 RII/RIII-type parasitologic failures, all with Day 2 MQ blood levels significantly lower than children whose parasitemias cleared before Day 7 and remained clear through 28 days. Predictors of RII/RIII parasitologic response were vomiting after MQ dosing, Day 2 MQ levels < 500 ng/mL, and undetectable Day 2 levels of the carboxymefloquine metabolite. There were 50 cases of delayed RI parasitologic failure, but 71% of these cases had undetectable Day 28 blood levels of MQ and drug levels in the remaining 29% ranged below the 620 ng/mL level that suppresses MQ sensitive strains of P. falciparum. Drug levels among infants that tolerated MQ well were not associated with age, weight, hemoglobin, parasitemia, and pre-existing symptoms of vomiting or diarrhea. An observed recurrent parasitemia of 34,400 trophozoites/μL against a MQ blood concentration of 550 ng/mL was taken as indication of tolerance to suppressive levels of the drug at this location. Copyright © 2007 by The American Society of Tropical Medicine and Hygiene.Item Severe anemia in young children after high and low malaria transmission seasons in the Kassena-Nankana district of northern Ghana.(American Journal of Tropical Medicine and Hygiene, 2000) Koram, K.A.; Owusu-Agyei, S.; Utz, G.; Binka, F.N.; Baird, J.K.; Hoffman, S.L.; Nkrumah, F.K.Malaria and anemia accounted for 41% and 18% respectively of hospital deaths in the Kassena-Nankana district of northern Ghana during 1996. We measured hemoglobin (Hb), malaria prevalence, and anthropometric indices of 6—24-month-old infants and young children randomly selected from this community at the end of the high (May–October, n 347) and low (November–April, n 286) malaria transmission seasons. High transmission season is characterized by rainfall (the equivalent of 800–900 mm/yr.), while the remaining months receive less than 50 mm/yr. Severe anemia, defined as Hb 6.0 g/dL, was 22.1% at the end of the high transmission season compared to 1.4% at the end of the low transmission season (Odds Ratio [OR] 20.1; 95% CI: 7.1–55.3). Parasitemia was 71% and 54.3% at these time points (OR 2.1; 95% CI: 1.5–2.9). Nutritional anemia appeared to have little impact upon this seasonal difference since anthropometric indices were comparable. Although the relative contributions of other causes of severe anemia were not assessed, repeated malaria infections may be a primary determinant of severe anemia among infants and young children during the high transmission season.