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A study in vivo of Plasmodium falciparum sensitivity to chloroquine was carried out from April 1997 to February 2000 at Yamoussoukro, Kossou and Bouaké in the central region of Côte d'Ivoire. This study was included in the national Plasmodium falciparum-sensitivity program. One hundred and sixteen subjects consulting for suspected malaria were included according to the WHO's standard of 14 days. Chloroquine was administered on a dosage of 25 mg/kg, spread over three days. Among 108 subjects who finished the treatment, 26.9% (29/108) had therapeutic failure to chloroquine (23 precocious therapeutic failure and 6 late therapeutic failure). Chloroquine was more efficacious in Yamoussoukro (87.5% of clinical appropriate response) and Bouaké (82.5%) than in Kossou (61.7%). Parasitic reduction on subjects with therapeutic failure was higher than 85%. The risk of therapeutic failure is not linked to age of patient. Before a revaluation of this situation, chloroquine should always be recommended as a first-line treatment for uncomplicated malaria for the local populations.

The therapeutic management of malaria in endemic regions is now hampered not only by the limited number of antimalarial agents, but also by the appearance of chemoresistant plasmodial strains and by the sometimes severe adverse effects related to the use of some of these drugs. Between January and July 1993, 100 patients presenting with symptomatic Plasmodium falciparum malaria were randomised to receive amodiaquine or chloroquine at the dose of 30 mg/kg for 3 days. The objective of this study was to compare the efficacy and safety of these two 4-aminoquinolines in the treatment of uncomplicated malaria. The parasite clearance was 4.87 (+/- 0.33) days in the amodiaquine group and 5.55 (+/- 0.31) days in the chloroquine group. All subjects in both groups were afebrile by D7. Cutaneous adverse effects, such as pruritus, were reported with both amodiaquine (3.2%) and chloroquine (6.8%). Amodiaquine was found to be significantly more effective than chloroquine in terms of parasite clearance on D7. The therapeutic failure rate was 0% for amodiaquine versus 16.3% for chloroquine. At a time when chemoresistance of Plasmodium falciparum, especially chloroquine-resistance, has spread to malarial endemic zones, amodiaquine should be very widely indicated in the treatment of simple malaria due to its excellent efficacy and good safety.

The authors reviewed the evolution of Plasmodium falciparum chloroquine resistance in greater Abidjan for the year 1990. They used the classical course of treatment consisting of 25 mg per kg of bodyweight distributed on three days. Parasitaemia and body temperature controls were carried out on day O, day 2 and day 7. The study, which involved 547 children averaging 38.3 months of age disclosed an early in vivo resistance in the range of 18.20% as against 29.6% in 1988.

A coprological study realized with 217 HIV adult subjects has allowed to evaluate the frequency of the cryptosporidiosis during this affection in Abidjan. Cryptosporidium sp. has been found in 8.7% of the subjects. Otherwise 78.9% of the patients had a chronic diarrhoea. 89.4% showed an abdominal pain and were dehydrated 94.7% had lost weight and 21% had nausea or vomiting.

Coprological survey involving 250 ivorian children with diarrhoea was done to evaluate the incidence of cryptosporidiosis. Crypstosporidium sp. was found in 10.4% of subjects. 76.9, 57.7 and 19.2% Cryptosporidium positive children had profuse diarrhoea, fever and pulmonary symptoms respectively. In Ivory Coast, children diarrhoeas due to cryptosporidiosis are quantitatively important.

In vivo tests of Plasmodium falciparum chloroquine sensitivity were conducted in October and November, 1988 with 81 children aged 5 to 9 in several districts of Abidjan, Ivory Coast. The WHO standard scheme covering 7 days on basis of 25 mg per kilo spread over 3 days resulted in a therapeutic failure in 29.6 per cent cases. Nevertheless, a drop in overall parasitemia by over 80 per cent was noted from Day-0 to Day-2 in 70 per cent of visible resistance. Only in vivo tests conducted at a later stage with identification of chloroquine in the blood stream, with together in vitro studies will make it possible to know the actual level of resistance of Plasmodium falciparum strains to chloroquine.

The authors study parasites of the six most commonly consumed species of fishes in Côte-d'Ivoire. Analysis of gills, alimentary canal and blood of 188 fishes reveal the presence of extremely diverse families of parasites.