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Medical Access to Quinine for Malaria Treatment Streamlined in Canada through the Canadian Malaria Network
Canadian Malaria Network (CMN)
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Malaria continues to be a major cause of death worldwide and is the principal life-threatening infection facing Canadian travellers in malaria-endemic areas. Severe Plasmodium falciparum malaria infections may have a mortality rate of 20% or higher. Patients require immediate hospitalization and urgent, intensive medical management, including parenteral malaria therapy.
Parenteral quinine, the preferred medication for the treatment of severe and cerebral malaria due to P. falciparum, has not been readily available in this country, except through Health Canada's Special Access Program. Although quinidine is equally efficacious in treating malaria, it has a risk of life-threatening cardiotoxicity and an associated requirement for cardiac monitoring.
Because of the potential for adverse outcomes due to delays in acquiring parenteral malaria therapy, the Canadian Malaria Network (CMN) has been established in 12 medical centres across Canada to facilitate the storage and rapid distribution of parenteral quinine for the treatment of severe P. falciparum infections. CMN Centres can provide, on request, guidance in the management of malaria infections. In addition, each Centre provides surveillance data to Health Canada on all malaria cases treated with parenteral quinine.
Upon request for parenteral quinine from any of the designated CMN Centres [see below for list], the attending physician will receive via courier delivery within 24 hours-a-day, 7 days-a-week:
- parenteral quinine supply, and
- relevant paperwork: information on treatment and chemotherapy for severe falciparum malaria, and surveillance data collection forms (Forms A & B).
The attending physician will be asked to provide surveillance information at time of diagnosis (Form A) and at day 28 (Form B) to the CMN National Coordinators.
Note: Fever occurring in a traveller within three months of returning from a malaria-endemic area is a medical emergency and should be investigated urgently with thick and thin blood films for malaria.
Table 1: Criteria for Severe Falciparum Malaria
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EITHER
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Adapted from: Severe and complicated malaria, 2nd ed. Trans Roy Soc Trop Med Hyg 1990;84(Suppl 2). |
Contact Information
The following hospital Centers across Canada have been identified as participants in the Canadian Malaria Network. Each Center will have depositories of parenteral quinine for the treatment of severe malaria and can provide guidance in the management of malaria infections.
To obtain parenteral quinine, please contact the listed pharmacy in your area. The designated physician for each Center can be used as a resource for any questions you may have with regard to the treatment of malaria.
For after-hours assistance please contact the infectious disease consultant on call at the respective center.
CMN National Coordinators
|
Name: |
Dr. Anne E. McCarthy |
Dawna Garber, RN |
|
Address: |
Director of Tropical Medicine and |
Research Nurse Coordinator |
|
Phone #: |
(613) 737-8184 |
(613) 737-8899 (ext. 8886) |
|
Fax #: |
(613) 737-8682 |
(613) 737-8580 |
|
E-Mail: |
amccarthy@ottawahospital.on.ca |
dgarber@ |
CMN Centres, by province
British
Columbia |Alberta | Saskatchewan | Manitoba | Ontario |
Québec
| Nova Scotia |Newfoundland
and Labrador
|
Name: |
Dr. William Bowie |
Dr. Tim Lau, Pharmacist |
|
Address: |
GF Stong Research Laboratory |
CSU Pharmaceutical Services |
|
Phone #: |
(604) 875-4147 or (604) 875-4111 (ID Physician on-call) |
(604) 875-4111, local 63361 |
|
Fax #: |
(604) 875-4013 |
(604) 875-5267 |
|
E-Mail: |
|
Name: |
Dr. Stan Houston |
Amy Lau, Pharmacist |
|
Address: |
2E4.11 WC Mackenzie Health Sciences Ctr. |
University of Alberta Hospital Pharmacy |
|
Phone #: |
(780) 407-7501 |
(780) 407-7707 |
|
Fax #: |
(780) 407-7137 |
(780) 407-7690 |
|
E-Mail: |
||
|
Name: |
Dr. Susan M. Kuhn |
Dr. Dominique Van Schijndel, Pharm. |
|
Address: |
Director, Odyssey Travel and Tropical Medicine Clinic, Suite
208-2004-14th St. NW |
Alberta Children's Hospital Pharm |
|
Phone #: |
(403) 210-4770 |
(403) 943-7204 |
|
Fax #: |
(403) 210-4775 |
|
|
E-Mail: |
Skuhn@MyTravelClinic.com | Dominique.vanschijndel@ calgaryhealthregion.ca |
|
Name: |
Dr. Karen McClean |
Lesley Odsen, Pharmacist |
|
Address: |
Division of Infectious Diseases |
Royal University Hospital Pharm. |
|
Phone #: |
(306) 655-1000 |
(306) 655-2264 or (306) 655-1000 |
|
Fax #: |
(306) 975-0383 |
|
|
E-Mail: |
|
Name: |
Dr. Pierre Plourde |
Anita Richard, Pharmacist |
|
Address: |
Winnipeg Regional Health Authority |
St-Boniface Gen. Hosp. Pharmacy |
|
Phone #: |
(204) 926-7079 or (204) 237-2053 (ID Physician on-call) |
(204) 237 2161 |
|
Fax #: |
(204) 926-8008 |
|
|
E-Mail: |
|
Name: |
Dr. Kevin C. Kain |
Tamara Rumsey, Sr. Pharmacy Technician |
|
Address: |
The Toronto General Hospital |
The Toronto General Hospital, University Health Network |
|
Phone #: |
(416) 340-3535 |
(416) 340-4800 ext. 3499 |
|
Fax #: |
(416) 595-5826 |
(416) 340-3685 |
|
E-Mail: |
||
|
Name: |
Dr. Anne E. McCarthy |
Kim Lamont, R.Ph. Tech. |
|
Address: |
Division of Infectious Diseases |
Ottawa Hospital - General Campus Pharmacy Department, 501 Smyth
Road |
|
Phone #: |
(613)737-8184 |
(613) 737-8899 ext. 72276 |
|
Fax #: |
(613) 737-8682 |
(613) 737-8891 |
|
E-mail: |
||
|
Name: |
Dr. Shariq Haider |
Gita Sobhi, Pharmacist |
|
Address: |
Microbiology and Infectious Diseases, McMaster University
Medical Centre |
McMaster University Pharmacy |
|
Phone #: |
(905) 521-2100 ext. 73991 (after hours (905) 521-5030, pager #8020) |
(905) 521-2100 ext. 73447 |
|
Fax #: |
(905) 521-4967 |
|
|
E-Mail: |
|
Name: |
Dr. Louise Côté |
Luc Bergeron, Pharmacist |
|
Address: |
Microbiology & Infectious Diseases |
Dept of Pharmacy |
|
Phone #: |
(418) 656-4141 poste: 7882 |
(418) 654-2139 |
|
Fax #: |
(418) 654-2147 |
(418) 654-2154 |
|
E-Mail: |
||
|
Name: |
Dr. Brian Ward |
Denise Kalyvas, Pharmacist |
|
Address: |
The Montreal General Hospital |
The Montreal General Hospital-Pharmacy |
|
Phone #: |
(514) 921-6953 or (514) 934-8075 |
(514) 937-6011 ext. 4933 |
|
Fax #: |
(514) 934-8347 |
|
|
E-Mail: |
|
Name: |
Dr. David Haldane |
Kathryn Slayter, PharmD |
|
Address: |
Microbiology Laboratory |
Pharmacy Department |
|
Phone #: |
(902) 473-6624 |
(902) 473-6829 |
|
Fax #: |
(902) 473-4432 |
(902) 473-1606 |
|
E-Mail: |
|
Name: |
Dr. Chau Nguyen |
Frank Pinsent, Pharmacist |
|
Address: |
Division of Infectious Diseases |
Department of Pharmacy |
|
Phone #: |
(709) 777-8437 |
(709) 777-6455 |
|
Fax #: |
(709) 777-7655 |
(709) 777-8120 |
|
E-Mail: |
