Malaria chemoprophylaxis for multiple drug resistant Plasmodium falciparum in Africa: an increasing problem.
Resistance of P. falciparum to the two groups of antimalaria drugs commonly used for prophylaxis, i.e. folate antagonists and 4-aminoquinolines has become a matter of great concern, also in Africa. After 1978, P. falciparum developed resistance to the group of 4-aminoquinolines, which was first reported from East Africa. Chloroquine resistant infections are now spreading into Central Africa. Similar developments are now appearing with the combination sulfadoxine/pyrimethamine. With the increasing reports of multiple drug resistance in P. falciparum from Africa, no single drug or combination of drugs in use for chemoprophylaxis can give a complete protection under all circumstances any longer. Until new effective drugs become available, it is advised to use the combination of chloroquine or amodiaquine and proguanil; the traveller should be prepared for action in the event of a breakthrough. A written instruction is suggested to be inserted in the "International Certificate of Vaccination".
D000328:Adult; D000349:Africa; D000962:Antimalarials / Q000627:therapeutic use*; D002738:Chloroquine / Q000627:therapeutic use; D004351:Drug Resistance; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008288:Malaria / Q000517:prevention & control*; D010963:Plasmodium falciparum / Q000187:drug effects; D011739:Pyrimethamine / Q000627:therapeutic use; D014195:Travel
D000962:Antimalarials; D002738:Chloroquine; D011739:Pyrimethamine