Chloroquine-resistant Plasmodium falciparum malaria in Vanuatu

Cases of malaria caused by Plasmodium falciparum resistant to chloroquine treatment have been probably occurring in Vanuatu for many years. In this survey, seven patients with P. falciparum malaria were investigated for evidence of resistance to chloroquine. In-vitro resistance to chloroquine was demonstrated in four. Two further patients who had clinical resistance to chloroquine treatment developed cerebral malaria. It is of interest that one of these patients was subsequently successfully treated with mepacrine. Two additional cases are cited as examples of resistance to chloroquine treatment encountered in the past.     

Subarachnoid haemorrhage in Plasmodium falciparum malaria

A 41 year old man with cerebral malaria was found to have numerous bilateral retinal haemorrhages and very high parasitaemia. Despite intensive treatment his condition deteriorated and he died. Autopsy showed subarachnoid haemorrhage, which has not been previously described in cerebral malaria.     

Guillain-Barr�� syndrome in Plasmodium falciparum malaria.

A patient with Plasmodium falciparum malaria developed peripheral neuropathy. Clinical, cerebro-spinal fluid examination and nerve conduction studies confirmed Guillain-Barré syndrome, not previously reported in P. falciparum malaria.     

45例重症恶性疟疾临床分析

目的探讨重症恶性疟疾的临床特点及防治.方法对45例病例的临床资料进行回顾性分析. 结果45例均为外来人口恶性疟疾,以脑型疟居多,占62.2%;黑尿热、妊娠疟疾等分别占13.3%和6.7%.严重并发症是急性肾功能衰竭、呼衰、多器官功能衰竭和冠心痛,经抗疟治疗和辅助治疗后死亡4例,治愈41例,治愈率为91.1%.结论恶性疟痰危重病症原虫治疗是根本措施,及时识别和合理治疗并发症是关键,加强对流动人口疟疾管理,预防为主要手段.     

恶性疟危重病例抢救治疗1例

在非洲加纳感染恶性疟病例回国后发病,患者以全身黄疸表现为主,就诊24h后出现意识障碍,几天的体温观察中均在37.8℃左右,血内原虫密度不高,血小板数值降低。经用青蒿琥酯注射液抢救治疗12h后患者清醒,24h后血内未查见疟原虫,血小板数值恢复正常。     

Plasmodium falciparum malaria mimicking autoimmune hemolytic anemia during pregnancy.

A 30-year-old woman contracted Plasmodium falciparum malaria in the first trimester of her pregnancy while taking chloroquine for malaria prophylaxis. Her illness was characterized by hemolytic anemia with IgG1 coating of the surface of the erythrocytes and IgG3 in her serum. The hemolysis subsided following treatment of the malaria infection early in the third trimester. She delivered at term an infant who had hypoplasia of the right tibia and fibula and absence of the fifth ray of the right foot. The hemolytic process was attributed to the malaria infection, and the birth defect may have been related to the antimalarial therapy in the first trimester of pregnancy.     

非洲婴幼儿恶性疟疾65例临床分析

目的探讨非洲婴幼儿恶性疟疾临床特点、诊治方法及其转归。方法回顾性分析确诊为恶性疟疾65例（其中脑型疟19例）住院婴幼儿的临床资料。结果65例恶性疟疾婴幼儿的血涂片均见到恶性疟原虫；临床表现以发热（100％），呕吐32例（49．2％），腹泻23例（36．9％），咳嗽27例（41．5％），抽搐12例（18．5％），意识障碍19例（29．1％），贫血52例（80．0％），脾肿大46例（71．6％），肝肿大41例（63．1％），脑膜刺激征19例（29．1％）。65例均接受青蒿琥酯抗疟的综合治疗，治愈60例，死亡5例。结论婴幼儿恶性疟疾临床表现复杂多样化且不够典型，尽早诊断、及时治疗是改善本病预后的关键；青蒿琥酯是治疗疟疾安全、有效的首选药物。     

恶性疟疾多价疫苗的构建及表达

目的 构建恶性疟原虫多表位融合抗原基因(PfCP2E9),并在毕氏酵母中进行高效分泌表达.方法 选取本实验室前期构建的融合蛋白PfCP-2.9与疟原虫红内期疫苗候选抗原EBA175IIF2,按一定的次序拼接成该融合基因,并克隆至酵母表达载体,用电转化方法将拼接基因导入毕氏酵母中进行分泌表达.结果 拼接的基因在毕氏酵母中高水平分泌表达.结论 构建的恶性疟原虫多表位融合抗原基因能在毕氏酵母中高水平分泌表达,为探讨其免疫学功能及作为多价联合疫苗的成分提供了基础.     

液氮冻存和复苏对恶性疟原虫存活的影响

自1976年Trager和Jensen成功建立了恶性疟原虫体外连续培养方法[1]以来,该方法已广泛应用于恶性疟原虫分子生物学及免疫学的研究.恶性疟原虫的冻存与复苏,是能否成功进行体外培养的关键.国内外研究者[2]对寄生虫冻存方法的探索已持续了半个多世纪,但就如何最大限度地减少低温对寄生虫的损伤,仍未得到规律性的结论.本实验对几种恶性疟原虫冻存复苏的方法进行了探讨,以期得到提高恶性疟原虫冻存后复苏成活率的更为有效的方法,为恶性疟原虫的体外培养提供有力的支持.     

Suppression of T-cell proliferative response in Plasmodium falciparum malaria patients--preliminary results

We report suppression of T-cell proliferative responses to P.falciparum specific antigen and mitogens. T-cells derived from malaria patients were co-cultured with P.falciparum antigen or mitogens and the T-cell activity determined by radioactive thymidine incorporation assay system. We found inhibition of T-cell responses to P.falciparum antigen in 13 out of 24 malaria patients studied. The suppression ranged from 4%-60%. Results of mitogenic responses of T-cells showed a wide variation. Suppression of concanavalin A (Con A) responses ranged from 48%-64% (4 out of 10 patients) while phytohaemagglutinin (PHA) responses varied from 4%-60% (8 out of 10 patients) and those of purified protein derivative (PPD) antigen from 12%-44% (3 out of 6 patients). Together, these preliminary results show a marked impairment in T-cell responses to parasite antigen and mitogens in P. falciparum infected patients.