Monitoring The Cure of Clinical-Parasitological Malaria in a Hospital of the Extra-Amazonic Region After Specific Chemotherapy

Abstract

Malaria is a serious public health problem in the world, reaching, according to the OMS, 40% of the population of more than 100 countries. The risk of acquiring malaria is not uniform inside a country, in addition of seasonal suffering and during the year. One of the main barriers to surveillance of malaria in a non-endemic area are due to the nonspecific nature of their symptoms relative to other acute febrile diseases (DFA), coupled with low and sometimes nonexistent clinical suspicion in that pathology. Consequently, in such situations, the clinical diagnosis has low validity. Given to the importance of diagnosing malaria for the early treatment of the individual, it was an objective in this research, search the cases of malaria in DFA individuals who had reported visiting or living in endemic areas of the disease and monitor the malaria clinical and parasitological cure by P. falciparum, P. vivax and/or P. malarie after specific chemotherapy. The diagnosis is done by a parasitological thick drop (parasitemia) and blood distention (identification of the species) examination, which currently represent the gold standard. The clinical-parasite treatment monitoring is done after the period of 6 weeks to evaluate the therapeutic response and possible detection of chemo resistance, as proposed by the Ministry of Health. The monitoring database of patients who look for an outpatient clinic of the DFA from August 2006 to March 2008 showed six cases of relapse in patients who did not return to the endemic areas, and for that reason, this work got some hypothesis to try to justify them.