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MCQs in Tropical Medicine

Rob Skelly DTM+H FRCP

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Answer 53

Effective malaria control interventions include:
False a. mass use of Fansidar chemoprophylaxis
True b. use of pyrethroid impregnated mosquito nets
False c. vaccination with SPf66
True d. larviciding
True e. eradication of mosquito breeding sites

Mass use of chemoprophylaxis is not usually feasible. Long-term use would be extremely expensive and it is not of proven efficacy. Use of chloroquine as chemoprophylaxis encourages the emergence of chloroquine-resistant strains. Furthermore the different dosage regimens for prophylaxis and treatment can be confusing for patients. For selected sub-groups such as infants and pregnant mothers and in areas of epidemic transmission, the case for prophylaxis is stronger. Fansidar is not recomended for prophylaxis.
Spf-66 (Patarroya vaccine) is not generally available and has not yet proved to be an effective control strategy. In one phase three trial it provided 55% protective efficacy.
Impregnated nets proved effective in trials but field experience is limited

Copyright: Rob Skelly 2006