PLASMODIUM-FALCIPARUM RESISTANCE TO MEFLOQUINE, CHLOROQUINE AND CYCLOGUANIL AND PREVENTION OF MALARIA IN TRAVELERS FROM FRANCE TO AFRICA

OBJECTIVES: Assess the efficacy of preventive and curative treatments of imported malaria. METHODS: The in vitro drug susceptibility of mefl oquine, chloroquine and cycloguanil was determined against African iso lates of Plasmodium falciparum from imported malaria cases by an isoto pic in vitro test or a genomic approach. RESULTS: Plasmodium falciparu m resistance to mefloquine, chloroquine or to the dihydrofolate reduct ase inhibitor was pre sent in 5.2%, 46% and 42% of isolates respective ly. Plasmodium falciparum drug resistance to chloroquine or antifolini cs was more frequent in permanent than in seasonal malarial transmissi on areas. Simultaneous resistance to chloroquine and antifolinics was observed in 17% of isolates between 1991 and 1994 and in 28% between 1 995 and 1997. CONCLUSION: An update of guidelines for the prevention o f malaria in travellers to Africa is suggested.