Malaria N° 9 - Subject N° 4

REVIEW OF THE SENSITIVITY / SUSCEPTIBILITY OF PLASMODIUM FALCIPARUM IN AFRICA WITH SPECIAL REFERENCE TO ZIMBABWE
S. Mutambu

SUMMARY
Plasmodium falciparum resistance to the available antimalarial drugs has been described in many parts of the world, especially in sub-Saharan Africa where malaria is endemic. P. falciparum resistance to the most widely used antimalarial drug, chloroquine, was first reported from Kenya in a tourist in 1979. Since then, many countries in Africa started to monitor the susceptibility of falciparum malaria infections to antimalarials using either the in vivo or in vitro tests. Results from these tests have shown that resistance to virtually all antimalarial drugs except for artemisinin and its derivatives exists in many parts of the continent. Chloroquine resistance of over 85% (of suitable cases tested in vivo) varying from RI to RIII levels have been reported. Sulfadoxine/pyrimethamine, amodiaquine and quinine resistance also exists in some parts of Africa. Resistance to mefloquine and halofantrine, though not widely used has been documented in a few countries including Zimbabwe.

Drug resistance continues to spread in Africa and it has become a major problem in the control of malaria in recent years necessitating the use of drugs which are more expensive. This review looks at the susceptibility of P. falciparum (the cause of more than 90% of all malaria infections) to antimalarial drugs in Africa with special reference to Zimbabwe. Research efforts and control measures that are being undertaken to map out, rapidly diagnose and control drug resistance in an effort to reduce morbidity and mortality due to malaria are also discussed.