The treatment of Plasmodium falciparum malaria in the Malagasy Highland Plateaux. Development of fever and parasite density. Clinical aspects

: In 1988, the sensitivity to chloroquine was investigated by the standard WHO in vivo test in 91 Plasmodium falciparum-infected individuals from the Highland Plateaux of Madagascar. As compared to the previous years, the level of resistance to chloroquine was increased, R2 resistant strains being present. This study also allows to define a policy for chloroquine therapy of patients. Following the malaria diagnosis by microscopy at DO, a single blood smear on D4 may indicate the parasitological cure for sensitive strains. However, 2 additional blood smears, on D7 and D14, are needed due to the presence of SR1, R1, and R2 strains. In all cases, a thick blood smear is required for microscopic observation, as the thin smear possess an insufficient threshold of sensitivity.