Open AccessChloroquine self‐treatment and clinical outcome of cerebral malaria in children
Author(s) -
PICOT S.,
NKWELLE AKEDE A.,
CHAULET J.F.,
TETANYE E.,
RINGWALD P.,
PRÉVOSTO J.M.,
BOUDIN C.,
AMBROISETHOMAS P.
Publication year - 1997
Publication title -
clinical & experimental immunology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.329
H-Index - 135
eISSN - 1365-2249
pISSN - 0009-9104
DOI - 10.1046/j.1365-2249.1997.d01-996.x
Subject(s) - chloroquine , cerebral malaria , malaria , medicine , immunology , plasmodium falciparum , intensive care medicine
Chloroquine is widely used as self‐medication for presumptive treatment of malaria despite the existence of parasite resistance to the drug. Recent studies suggest that tumour necrosis factor‐alpha (TNF‐α) overproduction probably has a causal association with poor outcome in cerebral malaria. In addition, chloroquine has been shown to have inhibitory action on TNF‐α synthesis. The present study aimed at evaluating chloroquine/TNF‐α interaction in 90 children hospitalized for severe malaria in a malaria‐endemic zone. TNF‐α and chloroquine varied in the same range on admission, but there was an inverse correlation between the two: the higher the chloroquine level, the lower the TNF‐α level. Parasite resistance to chloroquine in vitro was high. The clinical course in the patients was uneventful, save for two fatal cases and one survivor with neurological sequela. The above data suggest beneficial effects of chloroquine self‐medication with respect to anti‐TNF‐α action. Rational use of this tool should be encouraged.