Expert review -: Epidemiology of Plasmodium falciparum malaria and chemoresistance

Epidemiologic data on imported Plasmodium falciparum malaria in France and chemoprophylaxis is issued by two national reference centers, one dealing with imported malaria and the other with chemoresistance in malaria. In 1997, the imported malaria incidence rate was estimated at 9.46 cases per 100,000 inhabitants, with 2.6 parts per thousand imported cases per year (return from Africa). P. falciparum was reported in 85% of the cases and 98% of these were African strains. Twenty-four cases of airport malaria have been recorded since 1977 The mean death rate has reached 16 per year since 1985. These data are comparable to those of other European countries. Concerning chemoresistance, chemoprophylaxis was used in 282 reported cases of imported malaria (but if is difficult to define these as failed chemoprophylaxes). There was a higher risk of double resistance in parasites isolated from patients without chemoprophylaxis since 1991 in group 3 countries than in group 2, and this resistance increased between 1991-1994 and 1995-1997, notably in Benin. The reevaluation of malaria risks for travelers in this country led to changes in French recommendations on chemoprophylaxis. (C) 1999 Editions scientifiques et medicales Elsevier SAS.