Malaria, which affects about 600 millions people in the world, is the most widespread of the transmissible parasitic diseases. The causative agent is a microscopic parasite of the genus Plasmodium. The species P. falciparum induces the most serious form of this disease. Since the 1980s, African countries where malaria is endemic have been seeing the emergence of parasite forms resistant to the most widely used treatments, especially to chloroquine. Monitoring of the extent and distribution of such resistance therefore appeared necessary, in order to devise combined treatments (bitherapies) for controlling the disease.
With this objective in mind, researchers from IRD and OCEAC, in conjunction with the Cameroon Ministry of Public Health, assessed the efficacy of the antimalarial treatments most commonly used in Cameroon. In this country, because of the great diversity of landscapes and climates, the patterns of transmission of Plasmodium by mosquitoes differ according to the region, which makes it difficult to track changes and development in resistance (1).
The researchers determined the response in children with malaria, from 12 towns and villages in Cameroon, to three different monotherapies: two habitually prescribed as first treatment in that country (chloroquine and amodiaquine) and one issued as second intention medicine (sulfadoxine-pyrimethamine). The ineffectiveness of chloroquine was rapidly confirmed, with a very high proportion of therapeutic failure (48.6% on average), greater in the south than in the north of the country. That signalled a pressing need to rectify the treatment of the children concerned as soon as possible. This drug can no longer be considered a reliable treatment in Cameroon and its withdrawal from the market by the country's health authorities (in 2002) is justified. However, amodiaquine and, to a lesser extent, sulfadoxine-pyrimethamine are still effective treatments, with low therapeutic failure rates (an a
Contact: Marie Guillaume-Signoret
Institut de Recherche Pour le Dveloppement