[A fatal case of chloroquine-resistant neuromalaria in a traveller to Cameroon].

A death from chloroquinoresistant falciparum malaria contracted by a traveller under chloroquine chemoprophylaxis during a stay in the Cameroon provides the authors with an opportunity to analyze the extension of chloroquinoresistance in Africa. Having appeared there about 10 years ago, it remained for a long time localized in East Africa. In recent years, it has moved West. Today, 17 countries located from the North to the South between Sudan and Mozambique, and from East to West between Kenya and the Cameroon are affected, as are the Malagasy Republic, the Comores and Zanzibar. The strains resistant to chloroquine are still sensitive to amodiaquine. In certain regions which are widespread in the continent, resistance to pyrimethamine has become evident in the last 30 years; resistance to pyrimethamine-sulfadoxine and pyrimethamine-dapsone has appeared in the last 3 years in East Africa. In the light of the complexity of the problem of malaria chemoprophylaxis, the authors emphasize the necessity of resensitizing the public at large with respect to personal protection against biting anopheline mosquitos, especially during the hours of darkness. The medical profession should equally be made aware of these new problems. Three types of chemoprophylaxis in relation to the areas visited are proposed: the first for West Africa; the second for Central Africa, neighbouring regions and the Malagasy Republic and the Comores; the third for the 3 East Africa countries the most affected, which are Kenya, Burundi and Tanzania.