[Stability of P. Falciparum resistance to chloroquine between 1987 and 1989 in Mounana, Gabon]

Abstract

Between 1987 and 1989 the trend in the chloroquine resistance of Plasmodium falciparum in the mining town of Mounana in south-eastern Gabon was studied in vivo and in vitro in 58 and 158 subjects, respectively, aged from 1 to 15 years. The tests used were a simplified variant of the standard WHO 7-day test for the in vivo study and the isotopic semi-microtest of chemosensitivity for the in vitro study. The health situation in 1989 showed no change from the 1987 situation, but an increase in febrile symptoms suggestive of malaria was observed in 1989. This observation may be linked to a decrease in the distribution of chloroquine since 1987, accompanied by the use of other antimalarials following the appearance of chloroquine-resistant strains. While the parasitological efficacy in vivo remained the same in 1989, there was a decrease in the proportion of strains resistant to chloroquine in vitro compared to 1987; likewise, the therapeutic efficacy as estimated from temperature readings was better in 1989 than in 1987: the modification of the prophylactic strategy since 1986 and the drop in chloroquine consumption since 1987 could be responsible for a stabilization of chloroquine resistance at Mounana. The authors consider it appropriate in this region to continue treating malaria in children with chloroquine (in a dosage of 25 mg/kg) and to use a second-line treatment in the event of the recurrence of malaria symptoms within the next two weeks.