フィリピン,パラワン島のイワヒグ地域におけるクロロキン耐性熱マラリア〔英文〕
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概要
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1971年9月より翌年1月まで,および1973年1, 2月の2回にわたり,フィリピン,パラワン島のイワヒグ囚人部落(約390km^2,約4,000人)において,熱帯熱マラリア患者を対象にして,クロロキン耐性についての野外調査を実施した.クロロキンの標準投与量は25mg塩基量/kgとし,3日間に分割,経口投与を行ない,原虫検査期間は17日間と定めた.得られた成績を総合すると次の如くである.(1)原虫再燃は被検患者90人中44人(48.9%)に検出されそのうち40人はRI型を,4人はRII型を示した.(2)上記RI再燃患者44人にクロロキン35mg/kgを投与し,うち6人(RI型5人,RII型1人)に再燃を認めた.(3) RI再燃の検出は,治療開始後6日目の1例がもっとも早期で,以後日数の経過と共に検出例数の増加が見られた.(4) RI再燃群と治癒群間には,無性型原虫の血中より消失するまでの平均日数に有意差を認めなかった.(5)以上の成績から,本調査地域にはクロロキン耐性熱帯熱原虫が分布しているものとの結論に達した.A field examination on the chloroquine sensitivity of Plasmodium falciparum in acute infections was carried out in the Iwahig Penal Colony of Palawan Island, the Philippines, during the periods of September, 1971, to January, 1972, and of January to February, 1973. The standard chloroquine dosage to subject patients was 25 mg base/kg body-weight over 3 days and the follow-up examination for the parasites was made for 17 days (Day 0 to Day 16) on the subjects who were kept admitted in the medical units established in the survey area. Results obtained were as follows: (1) The recrudescence of asexual parasites was found in 44 (RI in 40, RII in 4) of 90 subjects examined (48.9%). Five RI recrudescences were additionally detected among 18 subjects who were examined during the shortened follow-up period. (2) To the 44 recrudescing patients, 35 mg chloroquine base/kg over 3 days was administered and 6 (RI in 5, RII in 1) of them exhibited recrudescence again, (3) In relation to the RI recrudescence cases to the standard dosage of chloroquine, the detection of the earliest recrudescence was done on Day 6 and the number of the detection of recrudescences on each day thereafter tended to increase as days passed until the end of the follow-up period. (4) In the number of days until the initial clearance of asexual parasitaemia from the beginning day of chloroquine administration, no significant difference was found between two groups of the RI recrudescence cases and the cured cases. (5) From the results obtained, it could be concluded that the falciparum strains resistant to chloroquine had distributed in the area of the Iwahig Penal Colony.
- 長崎大学熱帯医学研究所,Institute of Tropical Medicine, Nagasaki Universityの論文
長崎大学熱帯医学研究所,Institute of Tropical Medicine, Nagasaki University | 論文
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