Malaria transmission in a central area of Futa Djalon (Guinea): results of a parasitological survey during the 1989 rainy season.

A malaria survey based on household surveys and dispensary visits without notice was carried out during the rainy season of 1989 in three selected areas of central Futa Djalon (Republic of Guinea). Preliminary entomological evidence showed that Anopheles gambiae was the main vector in the area with a CS positive rate of 7.6% and a human blood index of 78% in August 1989. Indoor resting densities were highest in the rural village, lowest in Labé and intermediate in the town of Timbi Madina (median density per room of 18, 2 and 4.5, respectively). The household survey showed different parasite rates in the three areas: 78.2% of children had parasitaemia in Sombili, 45.8% in Timbi Madina and 16.7% in the urban sector of Labé. Prevalence and levels of P. falciparum antisporozoite antibodies were lowest in the urban area (seroprevalence of 51.9% and median titre of 2.4 arbitrary units), intermediate in the town (70.1% and 5.2) and highest in the rural village (78.9% and 5.8). Serological findings produced by dispensary visits were similar to those obtained with the household surveys except in the rural area, while parasitological data obtained with the two sampling methods were different both in rural and in urban areas. Routine malaria diagnosis made on a presumptive basis in the health services in the survey period was able to detect 30.1% of cases with parasitaemia and 53.2% of cases with hyperparasitaemia (sensitivity) and malaria was correctly not suspected in 82.8% of non parasitized people (specificity).