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Malaria N 9 - Subject N 13


THE EFFICACY OF ANTIMALARIAL DRUGS IN AFRICA
A. Aguye


SUMMARY
A large number of drugs are used in Africa for chemoprophylaxis and chemotherapy of malaria. Efficacious and safe drugs are necessary as weapons in the renewed interest in malaria control.

The most commonly used antimalarial drugs in Africa at the present time are chloroquine, sulfadoxine-pyrimethamine, mefloquine, fansimef® and artemisinin derivatives.

Several parameters can be used to assess the efficacy of antimalarials including clinical and laboratory data, Surveys and reports from various parts of the continent indicate that efficacy of antimalarial drugs vary from one area to another. In West Africa, chloroquine remains largely efficacious from the clinical point of view. Resistance has been reported for this agent as well as to sulfadoxine-pyrimethamine, amodiaquine and mefloquine. Data from East and Southern Africa show that resistance to chloroquine is more problematic and there is a general tendency to use second line drugs. In Central Africa, such as in Congo, Brazzaville, the response to common antimalarials are more encouraging than those from East and South Africa.

Resistance to antimalarial drugs show a patchy and very uneven picture throughout Africa, particularly chloroquine. The interpretation of the available data is fraught with many pitfalls as they do not derive from uniformly conducted studies. However the general consensus is that resistance to antimalarials is a problem that is hampering the fight against malaria.

A number of factors affecting the efficacy of antimalarials such as sociological factors among others have been identified and will be discussed. These include drug pressure and irrational use of antimalarials.


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