[Chemical resistance of Plasmodium falciparum in Africa. Current situation, implications for chemoprophylaxis]. / Chimio-résistance de Plasmodium falciparum en Afrique. Situation actuelle, implications pour la chimioprophylaxie.

Resistance of Plasmodium falciparum to antimalarial drugs is a growing worldwide problem in endemic areas. This is particularly obvious with chloroquine resistance which has been spreading throughout Africa since 1978. Initially localized on the Eastern coast of the continent, it has recently reached the Atlantic coast although Western Africa is as yet unaffected. This resistance has most probably arisen in the autochtonous population under the selective pressure of insufficient curative treatments as a result of self medication. It is most prevalent in children of urban areas but is often revealed in non immune expatriates. In addition, moderately resistant parasites in expatriates under chemoprophylaxis may lead to an insidious clinical form with a low or even negative parasitemia which raises diagnostic problems. Prophylactic and therapeutic schemes must take this new situation into account.