Current aspects of malaria in expatriates in the Central African Republic
Darie, H.; Reyle, Y.; Hovette, P.; Touze, J.E.
Medecine Tropicale Revue du Corps de Sante Colonial 51(4): 441-444
1991
ISSN/ISBN: 0025-682X PMID: 1800884 Document Number: 379310
Plasmodium falciparum malaria was diagnosed in 35 of 58 French expatriates living in Bangui, Central African Republic (a zone of RIII chloroquine resistance), presenting with asthenia, fever, shivering, sweating, myalgia, arthralgia, headache, splenomegaly, hepatomegaly, jaundice, pallor or digestive symptoms and who had not recently taken self medication with quinine, mefloquine or halofantrine. The clinical symptoms, and antimalarials taken as prophylaxis or as cures by malarial patients and the remaining 23 patients with diseases other than malaria were compared. This study demonstrated the frequency of atypical forms of malaria in areas of drug resistance and the inadequate information of expatriates regarding chemoprophylaxis (8 different prophylactic schedules were followed). Aspects of diagnosis are discussed and it is recommended that the acridine orange test should be used in addition to classical blood tests in order to detect low parasitaemias. 28 patients were given 2 courses of halofantrine, 7 were treated with quinine followed by halofantrine in 4 cases. Halofantrine alone failed in one case (suggesting the possibility of developing resistance) and this patient was treated with Quinimax, followed by a 3rd course of halofantrine and chloroquine (at 200 g/day) for one month.