Faits nouveaux relatifs a l'épidémiologie et au contrôle du paludisme en Afrique tropicale francophone

Abstract

In French-speaking tropical Africa various investigations have been made which have enabled workers to construct a map of endemicity ranging from the holoendemic area in the Ivory Coast, to hyperendemic areas in Guinea, North Dahomey, and parts of the Ivory Coast, to mesoendemic areas in Haute Volta, Ivory Coast and Cameroun. In most parts transmission varies seasonally, slight at the end of the dry season, vigorous in the rains. P. falciparum is the most common parasite (found in 80–90% of infected persons), and P. malariae is next, either alone or with P. falciparum; P. ovale exists from Liberia to Ghana, Togo, Nigeria and South Cameroun, and its distribution is strictly related to climate. P. vivax does not appear to be present. The vectors are A. gambiae (A and B, and melas) and A. funestus. A. gambiae A has been found resistant to DDT in Haute Volta and the Ivory Coast, and A. funestus to dieldrin in Haute Volta and North Dahomey. The extensive use of insecticides in agriculture is probably responsible for the selection of resistant anophelines. New insecticides are being studied in the region. Chemoprophylaxis, alone or with mosquito control, is regarded as of increasing importance, and experiments are being carried out in many places; resistance to pyrimethamine and proguanil has been found in various areas. Resistance to chloroquine has not been reported. A combination of pyrimethamine and sulphalene has proved as valuable as chloroquine.