scholarly journals Comparison of quinine-doxycycline and quinine-clindamycin for falciparum malaria in children

2011 ◽  
Vol 51 (4) ◽  
pp. 187
Author(s):  
Ditho Athos P. Daulay ◽  
Yunnie Trisnawati ◽  
Syamsidah Lubis ◽  
Munar Lubis ◽  
Syahril Pasaribu

Objective To compare the efficacy of quinine-doxycycline to quinine-clindamycin combination, as treatment for uncomplicated falciparum malaria in children.Methods This randomized open labelled controlled trial was conducted from July to August 2007 at Mandailing Natal, Sumatera Utara Province. The subjects were 8 – 18 year old children with positive Plasmodium falciparum from the peripheral blood smear. Simple randomization was performed to determine subject study into two groups of treatment, one group received quinine-clindamycin and the other received quinine-doxycycline treatment. The parasitemia was counted on day 0, 2, 7 and 28. We also observed the adverse effects of the antimalarial combination.Results Two hundred and forty six children who fulfilled the inclusion criteria were divided into two groups. All subjects completed the study. Cure rate achieved 100% from peripheral blood smear examination at the second day observation and showed no recrudescence at day 28th. (P=0.0001). During 28 days follow up, there were 21 (17.6%) patients suffered from headache, 18 (14.6%) vomit and 40 children (32.5%) suffered from tinnitus in quinine-doxycycline combination, compared to quinine-clindamycin combination group only 4 (3.3%) suffered from headache, 1 (0.8%) suffered from tinnitus and there was no vomiting experience in any patient (P < 0.0001).Conclusion Combination of quinine with either clindamycin or doxycycline are effective as an alternative antimalarial treatment. The combination of quinine-clindamycin is well tolerated than the combination of quinine-doxyciline, and this combination may be particular value for young children and pregnant women, as these two groups cannot receive doxycycline.

Biomedika ◽  
2020 ◽  
Vol 13 (1) ◽  
pp. 83-91
Author(s):  
Alex Jekson Tukira ◽  
Lucia Sincu Gunawan ◽  
Edy Prasetya

Anemia is a decrease in the number of erythrocytes in the blood circulation or the level of hemoglobin that is less than normal. The three major body mechanisms that cause anemia are excessive destruction of erythrocytes, blood loss, and decreased erythrocyte production. Based on the Basic Health Research (Riskesdas) in 2013, the prevalence of anemic women of reproductive age (WORA) aged 15-44 years in Indonesia was 35.3%. Anemia is classified based on the morphology of erythrocytes, including hypochromic microcytic, normocytic normochromic, and macrocytic. Erythrocyte morphology can be observed using peripheral blood smear examination. The objective of this study was to determine the morphology of erythrocytes in anemic women of reproductive age. This study belongs to descriptive research. The population of the study was 136 women of reproductive age, covering the students of D-IV in Medical Laboratory Technology at Setia Budi University. Forty-one respondents suffering from anemia were taken using a purposive sampling technique. The types of anemia were determined with examination using an Easy Touch hemoglobinometer with the Hb level of less than 12g/dL. Preparation of peripheral blood smear examination using EDTA venous blood and stained with Giemsa. Microscopic examination was performed with 1000x objective magnification. The peripheral blood smear reading showed the erythrocyte morphology that includes normocytic normochromic (38 samples or 93%), microcytic hypochromic (three samples or 7%), and poikilocytosis consisting of teardrop cells, target cells, ellipstocytes, and stomatocytes (five samples or 18%). Further study is required to investigate the correlation of erythrocyte index and peripheral blood smear in anemia.


2020 ◽  
Vol 10 (2) ◽  
pp. 1722-1727
Author(s):  
Rakesh Pathak ◽  
Sujata Pudasaini ◽  
Sushmita Ghimire ◽  
Anil Singh Basnyat ◽  
Anuj KC

Background: Anemia is a nutritional problem worldwide with an increased risk of morbidity and mortality in all age groups. Macrocytic anemia often originates from abnormalities that impair the erythroid precursor maturation in the bone marrow. Since the clinical manifestations of different types of anemias are similar, hematological parameters including hemoglobin, Red blood cell indices, and Peripheral Blood Smear examination are useful in the diagnosis of anemia. Materials and Methods: This was a cross-sectional study done in the Department of Pathology at Nepal Medical College Teaching hospital. A total of 42 patients between 14 to 62 years with low Hb concentration according to the World Health Organization criteria for anemia were selected and a mean cell volume > 100 fL was taken for study. Peripheral blood smear examination, Red blood cell indices, Vitamin B12, and Folic acid level were evaluated. Results: There were 42 patients with macrocytic anemia enrolled in the study with a mean age of 31.85±12.49 years and with female preponderance. Hemoglobin level was slightly low in males compared to females. Red blood cell indices were slightly higher in males. The difference of serum Vit B12 and Folic acid in male and female was found to be significant. Conclusions: It was concluded that for the diagnosis of a specific type of anemia, hemoglobin, Red blood cell indices, reticulocytes percent, and PBS examination were important parameters. Serum Folic acid and Vitamin B12 level estimation along with other hematological parameters are important for the diagnosis of macrocytic anemia and its correlation


Author(s):  
Reinaldi Octabiano G ◽  
I Nyoman Yesaya C ◽  
Zega Agustian ◽  
Yessi Setianegari ◽  
Christian Egia S ◽  
...  

Malaria is still a health problem in Indonesia. The number of malaria cases according to the 2018 RISKESDAS reached 8076 cases, and the highest number was obtained from Papua province with 3,334 cases. Multiple infection malaria in Indonesia according to RISKESDAS 2018, has a rate of 0.01% of the total cases, namely Plasmodium Falciparum malaria and Plasmodium non Falciparum malaria. A 47 year old man was referred from the clinic with complaints of high fever preceded by chills 10 days before being admitted to the hospital. Accompanied by shortness of breath, unable to get off the treatment bed due to feeling very weak, nauseous, sick and having a bulging stomach. Physical examination revealed a pale conjunctiva, ronkhi in the lower field of the right lung, dim percussion in the basal of the left lung, hepatomegaly, splenomegaly, shifting dullness. ring form vivax, on chest X-ray found a left pleural effusion. It is known that the patient previously lived in Papua from September 2018 to May 2019. During treatment, the patient was given artesunate injection therapy, dihydroartemisin + piperaquine and primaquin for seven days of treatment. At the end of the treatment, another chest X-ray was performed and re-examination of the peripheral blood smear, no more pleural effusions were found and no parasites were found on re-examination of the peripheral blood smear. Mixed infection of vivax and falciparum malaria, is a rare case that may occur in endemic areas where both plasmodium can be found. The prevalence in Indonesia according to RISKESDAS is only about 0.01% of all malaria cases in Indonesia.


2021 ◽  
Vol 28 (10) ◽  
pp. 1433-1437
Author(s):  
Rabiah Asghar ◽  
Javera Tariq ◽  
Nabeela Naeem ◽  
Anila Zafar ◽  
Khadija Qureshi ◽  
...  

Objective: This study aims to determine diagnostic accuracy of peripheral blood smear and automated haematology analyzer and to determine frequency of different types of anemia diagnosed by peripheral blood smear and automated hematology analyzer. Study Design: Cross Sectional study. Setting: Department of Pathology, Rawal Institute of Health Sciences, Islamabad. Period: November 2015 to April 2016. Material & Methods: Sample size of 149 suspected anemia patients was calculated using WHO calculator with 95% confidence interval. Research approval was taken from hospital ethical board. Patients were approached through non probability consecutive sampling method. Both peripheral blood smear examination and automated haematology analysis of each sample was performed. Diagnostic accuracy and frequency of anemia types was measured. Data analysis was done with the help of SPSS version 25. Chi-square and fissure exact test and ROC curve analysis was applied and significant (p<0.05) results were reported. Results: Total 149 patients were included in study. There were 42(28.2%) male and 107(71.8%) female.  Mean age of patients was 35.1±2.1SD. Peripheral blood smear and automated haematology analyzer showed sensitivity (68% vs 92%), specificity (59% vs 88%), PPV (72% vs 92%), NPV (55% vs 88%) and diagnostic accuracy (64% vs 91) respectively. Most common type of anemia diagnosed with peripheral blood smear was microcytic hypochromic anemia with raised RDW 36.7% followed by normocytic normochromic anemia with raised RDW 13.3% and macrocytic anemia (p=0.001) while in automated haematology analyzer microc ytic hypochromic anemia with raised RDW54.4% followed by normochromic normocytic anemoia with normal RDW 11.1% (p=0.000). Conclusion: Automated haematyology analyzer had high diagnostic accuracy for diagnosis of anemia.  Microcytic hypochromic anemia and normocytic normochromic are most common anemias diagnosed by peripheral blood smear and automated hematology analyzer and peripheral blood smear cannot be completely replaced by automated haemolytic analyzer. However, if both methods are used simultaneously, more accurate results can be obtained.


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