|1

2 |

.. 2551

(US Agency for International Development)

|3

4 |

.. 2551

ISBN

9
8
7
7
5

2551
15,000
978-974-297-722-1

11000
. 0-2590-3126, 0-2590-3134 | 0-2591-8422
21
1,3 .48 10700
. 0-2883-0417-8, 0-2883-4977 | 0-2883-0419

|5

50


-



.. 2528 .. 2538
.. 2547

2551

6 |

30
80
.. 2550 0.57
0.18

|7

8
8
9
9
9
10
12
14
14
14
15
15

16
17

-
-
-
-

17
17
19
20
20
20
21
21
22

8 |

3
(early diagnosis and prompt
treatment) (disease prevention)
(community participation)

1. (passive case)

2. (active case)


(. .)


1.
2.
3. 3

|9

(malaria chemotherapy)
5
1.
2.
3.
4.
5.

1. (presumptive treatment)

.. 2544

2. (radical treatment)

10 |

(P. falciparum)
(first line drug)
1

( .)

1
ATS
M
() ()

2
ATS
M
() ()

3
ATS
P
() (.)

ATS
M
P
() () (.)

14
(. 50 . )

30

12

30

8-13
(. 25-50 .)

1 12

15

3 12

15

3-7
(. 15-24 .)

1 12

10

2 12

10

1-2
(. 11-14 .)

3/4

1/2

1 14

6-11
(. 6-10 .)

1/2

1/3

5/6

()

6
2

ATS M 1
ATS Artesunate (ATS) 50 . 12 ./.
M 250 . 15 ./.
P 5 . 15 . 0.5 ./.
1. ATS

2
2.
3. 7
( 21)

| 11

/ 24-48




(second line drug)
1. 1
7 28 2
2. 1 2

()
()
()

( .)

()

()

14
8-13
3-7
1-2
6-11

42

14

30

21

15

14

3/4

10 1 2

1/2

6 1/2

()

42

42

()

(.)
()
()

10
5

0
0

14

30

12 |

5 300 . 8 ./.
100 . 100 .
5 . 15 . 0.5 ./.
1. 6

2.
3. 8

4.

(P. vivax) (P. ovale)

1.

3
1

()

14
8-13
3-7
1-2
6-11

4-14

1 2 3 1 1 1
C
C
C + P C + P C + P
P
C
() () () (.) () (.) () (.) (.) ()

P
(.)

15

15

15

15

10

210

10

10

10

10

140

70

2.5

2.5 1

2.5

2.5

35

1/2

0 1/2

6 1/2

1/2

0 1/2

1 12

10

()

C 250 . 25 ./.
P 5 15 .

| 13

1. C

2.
3.

2. 3
4
20 .

4

()

1
1 1
C
C
() ()

4-14
P
C
1 () ()

C
P
C
P
C
P
P
() (.) () (.) () (.) (.)

14
2
2
8-13
3-7
1
1-2
1
1
6-11
6 1/2

2
()

2
2
1
1
0
0

2
0
1
0
0
0

20
15
10
5
0
0

2
1
1
1
1/2
1/2

20
15
10
5
0
0

2
1
1
1
1/2
1/2

20
15
10
5
0
0

20
15
10
5
0
0

10
6
5
4
2
1 12

280
210
140
70
0
0

10

C 250 . 25 ./.
P 5 15 .
1. C

2.
3.

14 |

(P. malariae)

(mixed infection)
1
1 2 3
P. vivax 4

3. (chemoprophylaxis)

| 15

6 (chemoprophylaxis)
(.)

1 (.)

14
8-13
8 (24 . )

100
75

(WHO, 2000 pp.85)

4. (mass drug administration = MDA

selective drug administration = SDA)

5. (supportive drug)


1/2

16 |

..2538
2 .. 2539.
..2538
2 .. 2540.
2 .. 2546

.. 2546

.. 2547

Bosman A et al, The Use of Antimalarial Drugs Report of an Informal Consultation 13-17
November 2000. WHO/CDS/RBM/2001.33. 2001:141 pages.
WHO. Assessment and Monitoring of Antimalarial Drug Efficacy for the Treatment of
Uncomplicated Falciparum Malaria. Geneva: World Health Organization,
WHO/HTM/RBM/2003.50.
WHO. Management of Severe Falciparum Malaria. Second Edition Geneva: World Health
Organization 2000: 84 pages. (ISBN 92 4 154523 2)

| 17

4 (P. falciparum) (P. vivax)

(P. malariae) (P. ovale)
1

- -

80


( 20) 3
(incubation period) 2 (
18-40 ) (partial
semi-immunity)

(sporozoites)
(merozoites)

(schizonts) 6-30

(schizogony)

18 |

(hypnozoite)

(relapse)
(gametocytes)


(oocyst)
(sporozoites)

( 1)

1
Knell AJ. Malaria. Apublication of the Tropical Programme of the Wellcome Trust Oxford
University Press 1991.

| 19

4
(classic periodicity of febrile paroxysms)
48
1 3 72 ( 1 4)
(periodicity)
(periodicity)
(periodicity)
(brood of infection)

(synchronism)
(periodicity)

(uncomplicated malaria)

(no major organ dysfunction or failure)

(severe or complicated malaria)


(major organ dysfunction or failure)

20 |

1.

2. (rapid diagnostic tests)

1. (blood schizontocide)


2. (tissue schizontocide)
(hypnozoite)


3. (gametocytocidal)
4.

8
()
14+
8-13
3-7
1-2
6-11
<6
(WHO, 2000)

(.)
50+
25-50
15-24
11-14
6-10
<6

| 21

1-2

1. 2,500
100 ( 25 1 )
(schizont)
2.

39

4 .
3. 6
4. 3


5.

22 |

1. (chloroquine)
:
:
:
:
:
:
:
:
:

4-aminoquinoline
Diroquine, Genocin, Malarex
25 . /.
10
blood schizontocide gametocytocide
vivax, malariae ovale

2. (quinine)
:
:
:
:
:
:
:
:
:

cinchona alkaloid
Genin, Quinimax
10 . /.
10-12 .
blood schizontocide
chinconism

3. (mefloqine)
:
:
:
:
:
:
:
:
:

quinoline-methanol
Lariam, Mephaquin
15-25 . /.
10-20
blood schizontocide

4. (tetracycline)
:
:
:
:

antibiotics
Achromycin, Hydromycin, Lenocin, Pantocycline, Tetracyn, Tetrana, Tetrano
5-10 . /.
8 .

| 23

:
:
:
:
:

blood schizontocide

3

9

5. (doxycycline)
:
:
:
:
:
:
:
:
:

antibiotics
Amenmycin, Docline, Doxin, Doxy, Doxycline, Doxylin, Vibramycin
2 . /.
14-24 .
blood schizontocide

3

9

6. (primaquine)
:
:
:
:
:
:
:
:
:
7. (artesunate)
:
:
:
:
:
:
:
:
:

8-aminoquinoline
Neo-Plasmochin, Primaquine
0.5-1.0 . /.
5 .
gametocytocide

(hemolytic haemoglobinuria) enzyme G-6-PD
methhaemoglobinemia

1
sesquiterpene lactones
Artesunate, Plasmotrim
12 . /.
4-11 .
blood schizontocide reduce gametocyte carriage rate

24 |

686/2550

2550

1.
2.
3. .
4.
5. Dr.Charles Delacollette

1.

Coordinator, Mekong Malaria Programme, WHO

2.

3. . -

4.
3

5.
10

6.
12

7. .

8. ..

| 25

9. ..

10.

11. .

12.

13.

14.
1

1.
2.
3.

4.
5.
226/2547 20 2547
6 .. 2550

( )

26 |

| 27

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