On Resistance of Malaria to Medicinal Preparations Dr. Svistunov O.P. - Director of medical department ALSCON- RUSAL PLUNT in Nigeria, DTM&H ( Wits,SA), Dip.inf.dis.( Moscow,Russia), P.h.D in Cardiology (Tver. Russia), Member of Royal Society of Tropical Medicine (London). Dr. Anya Kalu, Dr. Ime Umoh. Isiwu Ifeanyi B.MLS(UNN),AIMLS(NIG),AM AMLSN(NIG), AM HPC(UK), Hospital ALSCON-RUSAL PLUNT in Nigeria. Ndifreke Ekop B.S.C, Almls Med.Microbiology, parasitology The question of treatment and prevention of all forms of malaria is currently one of the main unsolved problems. The development of new medical preparations on the base of artemezine, lumefantrine and meflakine has considerably lightened the work of doctors and scientists dealing with tropical medicine and seeking new medicinal forms in the fight with malaria. However the problem of resistance of malaria to preparations, used for the treatment of this disease, is not well studied on the background of associated diseases. The study of resistance of malaria to preparations containing artemezine, lumfatrine and meflakine was carried out on the base of АЗ Alscon in Nigeria. Irrespective of the form of malaria from the first days of study the patients were administered tablets Artemef, Coartem, containing artemeter and lumefantrine, as well as Artequin containing artezunate and meflakine. Because of side-effects meflakine was mainly administered for the treatment of malaria in males. Females and children received Coartem. Two groups of patients were examined. The first group consisted of new comers (expants) from those countries in which there are no malaria and other tropical diseases. The second group consisted of Nigerian employers and members of their families, residents of Nigeria who had survived malaria several times and other wide spread in this region diseases such as: amebiasis, candidosis, strongiloidosis, teniosis, filariosis. During the visit to the medical institution a patient was routinely checked up for the presence of malaria plasmodium in the blood and *** analysis was made for the presence of other parasitogenic diseases, clinical blood analysis and urine test were also made. We noticed that patients, who had suffered from malaria associated with amebiasis, candidosis and other intestinal infections, required re-treatment with antimalarial tablet preparations after parallel administration of antiparasitogenic preparations for the treatment of intestinal infections. But patients who had no associated intestinal invasions recovered after the first course of antimalarial therapy. After injections of Artemeter or Quinine preparations neither the first nor the second group of observed patients have required the repeated course of treatment. According to the data of WHO such diseases as amebiasis and candidosis are wide spread in those countries of Africa and Asia, where malaria is disseminated, and they affect about 80% of people. Nigeria is one of such countries and about 80% of people living around the clinics of АЗ Alscon in Aqua Ibom Province are infected by Entamoeba histolytica and suffer from systemic candidosis. The question has appeared: Are such associated intestinal diseases as amebiasis and candidosis the main cause of non-effectiveness of antimalarial tablets in the fight against malaria? This is the aim of our study. Materials and methods During the period from March 2007 to February 2008 we examined 100 specialists from Russia and countries UIS who worked and has been working at Alscon plant in Nigeria. We also examined 1000 Nigerian workers and members of their families. To diagnose the cases we used clinical data, methods of light microscopy, ultra sound diagnostics, colonoscopy and large experience of Nigerian specialists: laboratory workers, surgeons, gynecologists and therapeutists. Results Compared data during the period from March 2007 to June 2007, the beginning of rainy season, with the same period of 2008 the number of patients who has gone through malaria was 3-fold higher, and the clinical picture of malarial course in 2007 was differentiated from the clinical picture in 2008. Among the patients of the first group, consisting of the Nigerian staff and members of their families, malaria manifested classical clinical picture, probably because of late visit to the doctor. Patients of the second group, consisting of new comers, complained of herpes eruptions, pains in the back, sore throat, diarrhea, increased arterial pressure, dizziness. The rising of the body temperature was rarely marked. On examination of Nigerian patients the change of color of skin in the face was observed. It has required an unhealthy mat shade. The skin surface of new comers was mainly of the pale color. And only in those patients who had Entamoeba histolytica cysts, hyperemia of the skin was noticed on palpation (expants), especially in the region of abdomen. Acute tenderness in the right iliac region, along the large intestine, in the area of the sigmoid colon projection was also marked. The standard complex of analyses has been administered to all patients: light microscopy of the thin smear and the thick drop of the blood, stained by the method of Romanovsky – Gimze, analyses of stool and urine. Clinical and biochemical blood analyses were performed if it was indicated. In the first blood smear the number of revealed plasmodium was valued, and stool was examined on the presence of Entamoeba histolytica and fungi of Candida type according to the principle in one sight of vision from one to three . Overall 1000 Nigerians were observed. Of these 1000 patients 800 have been cured from malaria, but they were not affected by Entamoeba histolytica and fungi of Candida type. There were 200 patients with Entamoeba histlytica and fungi of Candida type. Not depending on the number of plasmodium in the blood of patients and the presence of Entamoeba histolytica anti malarial tablet therapy was administered. One hundred of expants catching malaria and infected by Entamoeba histolytica were also treated by the tablet preparations. Of the 800 Nigerians who had no Entamoeba histolytica infections and candidosis 735 patients have fully recovered. Of the 200 patients with Entamoeba histolytica and candidosis only 38 have recovered. The rest 65 patients who had no Entamoeba histolytica and 162 infected with Entamoeba histolytica and candidosis as well as 32 expants of a hundred infected with malaria have received the recapitulation course of the same antimalarial tablets and injections parallel with antiamoebic preparations Tinidazol and Metronidasol and anticandidosis preparations Diflukan, Ketokonasol, Nistatin. After the conducted course of treatment the repeated control analyses of the blood and stool of patients have been carried out. The results of the tests have not shown the presence of plasmodium in the blood as well as Entamoeba histolytica cysts or fungi of Candida type in the stool of all groups of patients. Conclusions As a result of our studies carried out in one of the most epidemically unfavorable Province of Aqua Ibom, where malaria, amebiasis and candidosis are wide spread, and according to the received data we may come to the conclusions: 1. Among the malarial patients having such associated diseases as amebiasis and intestinal candidosis the process of absorption of antimalarial drugs is disturbed. It requires simultaneous administrations of antiamebic, andicandidosis tablet preparations, contributing to the intestinal recovery from amebiasis and candidosis infections. These drugs effectively reduce the inflammatory process, restoring all functions of the gastro-intestinal tract and favorably effecting on the process of discharging the patients from malaria plasmodium. 2. In case of associated intestinal infectious diseases it is recommended to administer antimalarial preparations for intramuscular and intravenous injections combined with etiotropic therapy of gastro-intestinal tract.