IN-VIVO SENSITIVITY OF PLASMODIUM-FALCIPARUM TO CHLOROQUINE IN RURAL-AREAS OF COTE-DIVOIRE

In vivo testing of Plasmodium falciparum sensitivity to chloroquine wa s carried out in four rural sites of differing socio-geographical envi ronment in Cote d'Ivoire. Of a total of 1282 patients of ah ages with fever or previous history of fever, 649 were slide positive, with 435 patients with a pure P. falciparum infection; 191 fulfilled all the cr iteria for inclusion in this study, and 113 completed it. Treatment fa ilure rates ranged from 9.7% (Djebonoua) to 38.1% (Tieviessou), and we re most often associated with higher degrees of resistance (RII=54.2%; RIII=37.5%). Blood chloroquine levels measured by ELISA test suggest that many people take chloroquine routinely; furthermore 37.5% of resi stance cases occurred in subjects who had high blood chloroquine conce ntrations on day 0. Twenty-three out of 24 cases of resistance were fo und in children under 7 years of age. Nearly all children with persist ing parasitaemia were afebrile on day 7, even those (7/8) with RIII re sistance. Children aged <7 years represent the best sentinel group for monitoring P. falciparum sensitivity to chloroquine in Cote d'Ivoire.