[dr-ahmed]

Hi guys ,,

I always face a problem whenever dealing with a Q asking a bout malaria prophylaxis ,, in almost every question chloroquine and atovaquone/proguanil are listed as possible answers ,, and in the explanations it's written that chloroquine is the standard prophylaxis in chloroquine sensitive areas ,,,, but sometimes atovaquone/proguanil would be the right answer in chloroquine resistant areas :notsure: :notsure: :notsure: :notsure:
How do I know if this area has malaria that is sensitive or resistant to chloroquine?

 

[dr-ahmed]

Wttttttt !!!

Hay guys 60 views and no answers ,,, where are you Sabio

 

[Sabio]

Have a look at the Malaria Maps from CDC

You need to have some idea about the World's Malaria Map. No need to memorize each and every country, just get an overall idea.

Here's the maps for you

click image to enlarge

click image to enlarge

Copyright Notice: CDC maps are in the public domain
Ref:http://wwwnc.cdc.gov/travel/yellowbook/2010/chapter-2/malaria.aspx

 

[tkourkou]

As you can see in the map most of the countries that harbor malaria are below the equator. Now, you just want to remember only the chloroquine sensitive like mexico and Argentina. All the others are resistant. :happy:

 

[Seetal]

mexico n argentina!! awesome... thx!!

one should also want to remember the drug for the hypnozoite forms... primaquine (p.vivax, p.ovale)

 

[cool_atomic]

kaplan preventive medicine says that chloroquine is the DOC.
primaquine for hypnozoite forms, mefloquine/atovaquone-proguanil for chloroquine resistant forms, only atovaquone-proguanil for pregnant women.

regarding patterns of resistance, areas near the USA like mexico, latin america and central south america are chloroquine sensitive.
africa, south-east asia and all other countries where malaria is way more common than the US are chloroquine resistant, so if the area is far from the american continents, it'd be safe to guess other Tx rather than chloroquine.
Hope this helped~!~

 

[Seetal]

Yes that helps. So thoser r not resistant areas - argentina n mexico.

In asia however wher malaria is common, symptoms mite b as vague as headaches n malaise. Do u think d step 2ck will ask bout malaria using vague clinical symptoms as such?

 

[cool_atomic]

after all, this is US-MLE and they won't be concentrating on Asia that much and I believe that step-2CK is mostly about typical clinical presentations as any disease as grave as cancer can also have atypical presentation and stay asymptomatic till the end.

 

[khanar]

You still need to know it

after all, this is US-MLE and they won't be concentrating on Asia that much and I believe that step-2CK is mostly about typical clinical presentations as any disease as grave as cancer can also have atypical presentation and stay asymptomatic till the end.

NO. they still want you to know that because USA is full immigrants from these countries.

 

[cool_atomic]

This is about prophylaxis, not treatment.

this is about malaria prophylaxis! means that people want to get medicines in order not to suffer from malaria, not to get treated (which is called treatment). Although its about immigrants, it's not about those coming to usa but those wanting to leave the us for a trip or a tour and then come back to the usa, so we prophylax them obo where they are going.

 

[Seetal]

u r rite!

so we do have to know about it because we need to be sure we give the right prophylaxis med rite? anyways knowing a little extra couldn't hurt really.)

 

[cool_atomic]

yes! you have to know the treatment also, if not for the exam, you may and most probably will see cases in ur career!
This post is about prophylaxis and thats the reason why i was saying that!!!