On a rerun of MAS*H last night there was a big kfauffle over the fact that they’d ordered chloroquine for malaria prevention and got paludine instead (which isn’t a preventative medicine, it’s a controlative. Or something.)
The docs agreed it would suffice but wondered “what about the negroes?” because apparently blacks were at higher risk for complications from paludrine than others.
So, what ABOUT the “negroes”? From what I’ve read briefly about paludrine, it messes with your blood cells. Is this just a case of “blacks are prone to sycle cell anemia, and paludrine can make you anemic, and we don’t want that” or is there something else that separates the blood of those with African heritage from those with Europen heritage?
FWIW, Klinger and some other aide ended up getting side effects from the drug and they decided the drug was colorblind. awww.
Because some Middle Eastern People have the sickle cell trait or a verison of it…and East Asians…and Mediterraneans.
If that’s the case, then Paludrine would only affect some African-Americas, and Middle Easterners, and East Asians and Mediterraneans and any “Europeans” that had a certain amount of admixture from the affected populations.
Looking around it seems Paludrine is actually sometimes used to treat sickle cell anemia, no? Besides I was under the impression carriers of sickle-cell genes were almot immune from Malaria in the first place.
I am not 100% sure of my diagnosis here (it’s been a long time since I cared for live people), but I do believe that if you have a deficiency of G-6-phosphate, certain antimalarial drugs are very dangerous in that they may bring on an episode of hemolytic anemia. I didn’t see “paludrine” in their Table 2 under Clinical, but I’ve never heard the word before, and I wonder if it wasn’t a 1950’s name for primaquine.
Some people are born with a deficiency of G-6-phosphate on their red cells. This isn’t an accident, and it isn’t an accident either that the people who have it are either from the Mediterranean, Africa, or Lebanon. It confers some resistance to malaria if you are born with it. So it’s another version of the same thing sickle cell anemia and thalassemia may do for the body. I believe there’s yet another blood mutation in the Hmong that confers malarial resistance. Ironic, isn’t it, that some antimalarial drugs can cause these very malaria-resistant blood cells to burst open in the bloodstream like so many little red bombs.
I may not be clinical, but I know we do a hell of a lot better job tiding people through a severe episode of hemolytic anemia today than we could in the 1950’s, and they may still end up with renal damage. Or dead. Death would have been a very worrisome possibility in Korean War-era days.