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WHO model prescribing information: Drugs used in parasitic diseases
848 H, in: Flora Zambesiaca, .Exell & Wild (editors), vol. 1, part 2, -p. 369). _ Bruce J. Hargreaves
National Museum and Art Gallerv 331 Independence Avenue * Private Bag 00114 Gaborone Botswana
27 March 1991
IBook Reviews1 WHO Model Prescribing Information: Drugs used in Parasitic Diseases. Geneva: World Health Organization, 1990. 126 pp. Price SW. fr. 21; US $ 18.90; in developing countries, SW. fr. 14.70. ISBN 92-4140102-8. The World Health Organization’s ‘revised drug strategy’ was adopted in 1986 at the 39th World Health Assembly. The ruison d’8tre was to complement the WHO’s ‘Model List of Essential Drugs’, by providing ‘source material’ which national authorities, especially those in developing countries, could use in the compilation of ‘national drug formularies, drug compendia, and similar material’. A great deal of work clearly went into the production of this attractively produced paper-backed book; numerous individuals and organizations produced drafts which were reviewed by the WHO’s Expert Advisory Panel on Drug Evaluation, selected members of the various WHO Expert Advisory Panels on parasitic diseases, and others. Each entry concerning a chemoprophylactic or chemotherapeutic agent is preceded by a brief account of the parasitoses under consideration. A series of headings is used to categorize available information about agents currently -in use for protozoa1 and hehninthic infections: general. and clinical information (use(s), dose, rou’te of administration, contraindications, use in pregnancy (and lactation), adverse effects, drug interactions, overdose, storage, etc). Dehydroemetine and chloroquine are listed as agents for use in Entumoeba histolytica infections; in the days of the 5nitroimidazoles one wonders whether this is strictly necessary. Likewise, levamisole, piperazine, and pyrantel are included (for use in intestinal nematode infections). Praziquantel does not receive a mention in the section on hydatidosis. Although general guidelines are given for the chemotherapy of babesiosis, free-living amoebic infections, and capillariasis, in no case is there information on dosage. Also, there is a paucity of information on the newer agents (some still undergoing clinical trial); these include interferon-y, ketoconazole and itraconazole infections)! and eflornithine (o(in Leishmania difluoromethylornithine) which, despite a brief mention under ijyPanosoma gambiense- infection, lacks detail of dosage. etc. This elegant and ‘easy-to-use book is comp’ieted with a sh&t index. _ In summary, a mine of admirably concise and accurately compiled data is available at a reasonable price, which will be of enormous value to the .health departments of developing countries-the principal target audience. It forms part of a series; a companion volume ‘Drugs used in anaesthesia’ was apparently published before this one. The overall project has
obviously been well thought out and the not inconsiderable amount of work involved will be guaranteed a just reward. G. C. Cook Practical Chemotherapy of Malaria. Report of a WHO Scientific Groun. Geneva: World Health Oreanization, 1990. Tech&al Report Series, no. 805. 141 pp. Price US$ 14, SW.fr. 16 (in developing countries, SW. fr. 11.20). ISBN 92-4-120805-8. The latest in the series of WHO reports on the chemotherapy of Plasmodium spp. was composed by a team of 8 who met at Geneva in June 1989; 5 originated in a developing country and the others in the USA, USSR and UK, respectively. The target audience, according to the introduction, is ‘rniddlelevel planners and administrators who are responsible for a malaria service, but...research workers, clinicians, and primary health planners may find it a useful guide to understanding the factors that influence the choice of drugs for the treatment of malaria’. In stressing the d:fficulties involved in providing ‘common guidelines for WHO’s member states’. the authok quote L. W. Hackett, who in 1937 remarked: ‘Clearly governments can trust no formulas devised in Geneva or elsewhere, but must create the simple machinery necessary to define and resolve their own problems, locality by locality’. Who could disagree with that? The major substance of the text (55 pages) is devoted to the ‘management and treatment’ of uncomplicated, followed by severe, P. falciparum malaria. General measures, choice of an appropriate chemotherapeutic agent, toxic effects, and problems encountered in special groups (including pregnancy and infancy) all receive accurate, and generally orthodox, coverage. The difficult area of chemoprophylaxis (13 pages) is less well done; indeed it is difficult to find any didactic guidelines on the best agent (and dose) to take in any specific geographical location, although the overall problems surrounding this complex field are well discussed. What place, for example, does mefloquine have, and in which areas should n be used by the traveller? With the emergence of so much resistance to widely used chemoprophylactic and chemotherapeutic agents, the urgent need for ‘new’ compounds is obvious. This section (23 pages) is excellent; halofantrine is given ‘pride of place’, and is followed by artemisinin and its derivatives. But there are other lesser known agents also waiting in the wings; some of these will, hopefully, prove both safe and effective, also. Other important areas to receive due attention are covered in the sectionsdevoted to ‘General considerations for the development of a malaria treatment policy’, ‘Some aspects of diagnosis’, ‘Monitoring systems’, and ‘Procurement and distribution of antimalarial drugs’. The last-mentioned section contains a valuable account of ‘Pricesand pricing policies’. This slim paper-backed volume, like all of its predecessors, is presented in dark blue livery and is rounded off by a section on ‘Conclusions and recommendations’: all sections end with a well chosen bibliography, but as usual there is no index. All physicians and health care workers dealing with the human malarias should have access to this
National Museum and Art Gallerv 331 Independence Avenue * Private Bag 00114 Gaborone Botswana
27 March 1991
IBook Reviews1 WHO Model Prescribing Information: Drugs used in Parasitic Diseases. Geneva: World Health Organization, 1990. 126 pp. Price SW. fr. 21; US $ 18.90; in developing countries, SW. fr. 14.70. ISBN 92-4140102-8. The World Health Organization’s ‘revised drug strategy’ was adopted in 1986 at the 39th World Health Assembly. The ruison d’8tre was to complement the WHO’s ‘Model List of Essential Drugs’, by providing ‘source material’ which national authorities, especially those in developing countries, could use in the compilation of ‘national drug formularies, drug compendia, and similar material’. A great deal of work clearly went into the production of this attractively produced paper-backed book; numerous individuals and organizations produced drafts which were reviewed by the WHO’s Expert Advisory Panel on Drug Evaluation, selected members of the various WHO Expert Advisory Panels on parasitic diseases, and others. Each entry concerning a chemoprophylactic or chemotherapeutic agent is preceded by a brief account of the parasitoses under consideration. A series of headings is used to categorize available information about agents currently -in use for protozoa1 and hehninthic infections: general. and clinical information (use(s), dose, rou’te of administration, contraindications, use in pregnancy (and lactation), adverse effects, drug interactions, overdose, storage, etc). Dehydroemetine and chloroquine are listed as agents for use in Entumoeba histolytica infections; in the days of the 5nitroimidazoles one wonders whether this is strictly necessary. Likewise, levamisole, piperazine, and pyrantel are included (for use in intestinal nematode infections). Praziquantel does not receive a mention in the section on hydatidosis. Although general guidelines are given for the chemotherapy of babesiosis, free-living amoebic infections, and capillariasis, in no case is there information on dosage. Also, there is a paucity of information on the newer agents (some still undergoing clinical trial); these include interferon-y, ketoconazole and itraconazole infections)! and eflornithine (o(in Leishmania difluoromethylornithine) which, despite a brief mention under ijyPanosoma gambiense- infection, lacks detail of dosage. etc. This elegant and ‘easy-to-use book is comp’ieted with a sh&t index. _ In summary, a mine of admirably concise and accurately compiled data is available at a reasonable price, which will be of enormous value to the .health departments of developing countries-the principal target audience. It forms part of a series; a companion volume ‘Drugs used in anaesthesia’ was apparently published before this one. The overall project has
obviously been well thought out and the not inconsiderable amount of work involved will be guaranteed a just reward. G. C. Cook Practical Chemotherapy of Malaria. Report of a WHO Scientific Groun. Geneva: World Health Oreanization, 1990. Tech&al Report Series, no. 805. 141 pp. Price US$ 14, SW.fr. 16 (in developing countries, SW. fr. 11.20). ISBN 92-4-120805-8. The latest in the series of WHO reports on the chemotherapy of Plasmodium spp. was composed by a team of 8 who met at Geneva in June 1989; 5 originated in a developing country and the others in the USA, USSR and UK, respectively. The target audience, according to the introduction, is ‘rniddlelevel planners and administrators who are responsible for a malaria service, but...research workers, clinicians, and primary health planners may find it a useful guide to understanding the factors that influence the choice of drugs for the treatment of malaria’. In stressing the d:fficulties involved in providing ‘common guidelines for WHO’s member states’. the authok quote L. W. Hackett, who in 1937 remarked: ‘Clearly governments can trust no formulas devised in Geneva or elsewhere, but must create the simple machinery necessary to define and resolve their own problems, locality by locality’. Who could disagree with that? The major substance of the text (55 pages) is devoted to the ‘management and treatment’ of uncomplicated, followed by severe, P. falciparum malaria. General measures, choice of an appropriate chemotherapeutic agent, toxic effects, and problems encountered in special groups (including pregnancy and infancy) all receive accurate, and generally orthodox, coverage. The difficult area of chemoprophylaxis (13 pages) is less well done; indeed it is difficult to find any didactic guidelines on the best agent (and dose) to take in any specific geographical location, although the overall problems surrounding this complex field are well discussed. What place, for example, does mefloquine have, and in which areas should n be used by the traveller? With the emergence of so much resistance to widely used chemoprophylactic and chemotherapeutic agents, the urgent need for ‘new’ compounds is obvious. This section (23 pages) is excellent; halofantrine is given ‘pride of place’, and is followed by artemisinin and its derivatives. But there are other lesser known agents also waiting in the wings; some of these will, hopefully, prove both safe and effective, also. Other important areas to receive due attention are covered in the sectionsdevoted to ‘General considerations for the development of a malaria treatment policy’, ‘Some aspects of diagnosis’, ‘Monitoring systems’, and ‘Procurement and distribution of antimalarial drugs’. The last-mentioned section contains a valuable account of ‘Pricesand pricing policies’. This slim paper-backed volume, like all of its predecessors, is presented in dark blue livery and is rounded off by a section on ‘Conclusions and recommendations’: all sections end with a well chosen bibliography, but as usual there is no index. All physicians and health care workers dealing with the human malarias should have access to this