DYNAMICS OF PLASMODIUM-FALCIPARUM GAMETOC YTEMIA ACCORDING TO THE THERAPEUTIC RESPONSE TO CHLOROQUINE IN A MESOENDEMIC AREA

Patients with Plasmodium falciparum infections were selected with an i n vivo chloroquine sensitivity assay in a mesoendemic area of Senegal. Gametocytemia was studied in relation to asexual parasite responses c lassified as drug-sensitive or showing RI or RII resistance. Gametocyt e prevalence and density appeared significantly higher in resistant in fections than in sensitive ones. These observations were made on child ren as well as on adults. The period between first clinical symptom ap pearance and: treatment, varying from 0 to 5 days, was not linked to a sexual parasite responses, but was significantly and positively correl ated to gametocyte prevalence and density observed seven days after be ginning the treatment The comparison between these results and those p reviously observed ina hypoendemic area suggests that the dynamic of g ametocytemia is independent of the endemic level. These observations i llustrate that the dissemination of chimioresistant malaria can be rei nforced - via the gametocyte stage - by selective chloroquine pressure .