[Falciparum malaria in East African tourists in spite of fansidar prevention. A contribution on increased chloroquine and pyrimethamine-sulfadoxine resistance in areas of East Africa].

A decreased chloroquine (Resochin) sensitivity of strains of Plasmodium falciparum in certain areas of East Africa has given rise to an inappropriate change of chemoprophylaxis to pyrimethamine-sulfadoxine (Fansidar). Falciparum malaria occurred in five tourists during or after Fansidar prophylaxis. A therapeutic chloroquine-R2-resistance was observed in one seriously ill patient. In some patients the course of disease was prolonged to such an extent that the diagnosis could be established only after as much as 4 months after the end of the journey. This was in part surely caused by intake of anti-plasmodial drugs such as sulfonamides, tetracyclines and co-trimoxazol. The high mortality of falciparum malaria of nearly 10% in this country does not depend on the choice of drug prophylaxis or on problems of resistance, but still on a missed or delayed diagnosis.