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[08/04/2005]
 Burkina Faso
 < Back to the list 
Acknowledgements 
Dr Joseph Waodogo CABORE, Ouagadougou, Burkina Faso
Mme Dominique LOUIS-LUTINIER, Yaounde, Cameroon.
Mme Odile SOSSAT, I.M.T.S.S.A. Le Pharo, Marseilles, France


Dr Francis LOUIS, Yaounde, Cameroon


> General statistics | > Epidemiology of malaria | > The parasites and the chemoresistances | > Chloroquine-resistance | > The vectors and the antivectorial fight | > The Treatment of Malaria | > Advices to travelers | > Bibliography

 General statistics
- area: 272,528 km2
- population: 10 millions 
- official language: French
- currency: Franc CFA (1 euro = 656 FCFA)
- bordering countries: Mali, Niger, Benin, Togo, Ghana, Ivory Coast 
- capital city: Ouagadougou (900,000 inhabitants)
- main cities: Bobo Dioulasso (300,000 inhabitants), Koudougou (73,000 inhabitants), Ouahigouya (51,000 inhabitants), Banfora (51,000 inhabitants), Gaoua, Dori, Dédougou, Fada-Ngourma, Tenkodogo

Burkina-Faso is a landlocked country, in the heart of West Africa.  Its hydrographic network comprises permanent rivers - all located in the south and south-west of the country (Mouhoun, Comoé, Léraba), and rivers which are dry a large part of the year (Nakambé, Nazinon, Beli, Sirba, Tapoa).
Climat is tropical-Sudanese, marked by two inequal seasons: a long dry season, from October to April, and a short rainy season, from May to September. 
From the south to the north, there are three distinct climatic zones:
- a south-Sudanese zone: mean annual rain fall from 1,000 mm to 1,300 mm, extreme temperatures from 12°C to 38°C ;
- a north-Sudanese zone: mean annual rain fall from 650 mm to 1,000 mm, extreme temperatures from 13°C to 40°C ;
- a Sahelian zone: mean annual rain fall lower than 650 mm, extreme temperatures from 10°C to 42°C.

The population of Burkina-Faso is young (46 % under 15) and rural (80 %).  The country is divided into 45 provinces, 350 Départements and 8,228 villages. 
The agricultural sector provides 30 % of the GDP, 60% of export revenus, and it employs more than 80% of the population. Cattle farming represents 10 % of the export revenus (132).
 Epidemiology of malaria

Malaria is endemic over the whole of Burkina-Faso.

J-M. Amat-Roze and G. Rémy have identified two different zones:
- a south-Sudanese zone: the transmission period associated with hibernation, is intense, continuous and spatially homogeneous.  During the dry season, climatic conditions are unfavorable to anopheles only in short periods.  Certain breeding grounds remain permanently active and ensure a perennial transmission.  Other water collection points stay epidemiologically dangerous.
- a Sahelian zone: hibernation is short and the limited rain falls, temporo-spatially random, makes for a discontinuous transmission in each location, even more so as the grounds are most often sandy and well drained.  The rain waters disappear rapidly.  Only the large ponds and certain rivers enable regular production of breeding grounds.
The sedentary populations, rooted near the water points, are exposed to an intense transmission during the hibernation.  The nomadic, mobile and scattered populations are only exposed to occasional transmission (11).
 
Today, the transmission of the disease is defined as stratas corresponding to the  climatic zones (132): 
- permanent in the south-west south-Sudanese region, with an increase during the rainy season and at the beginning of the dry season;
- long - June to March - in the central north-Sudanese zone; 80 % of malaria attacks are recorded between July and October in Ouagadougou (77).
- short - July to November - in the Sahelian tip ; 95% of the malaria attacks occur between July and November, and 90% of the attacks affect children under the age of 15 (46). 

In the south-Sudanese zone, more than 20% of the patients consult for fever and malaria corresponds to 30 % to 35 % of the fevers.  During the rainy season, however, malaria causes 43% of the fevers and this rate can climb up to 76 % in October (19, 48, 65).

The diversity of the epidemiological facies, according to the epidemiological strata (north, centre, south), to the season (dry, rainy), and to the location (urban , rural), translates into a significant variation of the plasmodic indexes (PI) (85):
- Dori (north, urban): PI = 27 % to 29.5 %
- Koudougou (centre, urban): PI = 21.4 % to 67.7 %
- Zaghtouli (centre, rural): PI = 44.6 % to 68.9 %
- Fada N'Gourma (centre, urban): PI = 23.5 % to 44.5 %
- Banfora (south, urban): IP =  23.2 % to 41.6 %

In Ouagadougou, the plasmodic index varies from 9.5 % to 26.4 % depending on the season. In the neighbouring rural environment, it ranges from 50.9 % to 87.9 % during the same periods (25).  According to Sabatinelli et Coll., the mean plasmodic index in Ouagadougou is 29.4 % (25).

According to D. Modiano et Coll., differences associated with the way of life - urban or rural - have an impact on the epidemiology and on the clinical expression of severe malaria (154):


Environmenturbanrural
Mean age at admission4.8 ± 3.02.2 ± 1.9
Prevalence of coma53.6 %28.9 %
Prevalence of severe anemia14.8 %47.4 %


 The parasites and the chemoresistances
Plasmodium falciparum is the most common species in Burkina-Faso: 96.35 % to 98.5 % in Bobo-Dioulasso (01, 65), 98.6 % in Ouagadougou (25), 95 % in the north (46).
With a frequency of 4.4 % to 5.4 %, Plasmodium malariae is far behind (01, 25). 
Plasmodium ovale represents less than 2 % of the plasmodial species isolated (01. 25).
Plasmodium vivax has not been isolated in Burkina-Faso.
 Chloroquine-resistance
Chloroquine-resistance does not seem to be a serious public health issue in Burkina-Faso.

Chloroquine-resistance was envisaged in vivo in 1965, but not evidenced (03).

Tests carried out in 1966 (04), 1973 (09) and 1983 (15) did not evidence this resistance.

The first mention of a sensitivity drop dates back to 1987 (36): out of 431 in vivo tests, 3 RII were evidenced (0.7 %) (36). A chloroquine-based prophylaxis failure was clinical described for the first time in 1988 in the Cochin Hospital in Paris, concerning a 72-year old patient returning from a short stay in Burkina-Faso (38).

The results of the studies carried out as of that date are compiled in table I. It shows that the in vivo resistance rates have varied: 
- in Bobo-Dioulasso: from 0.7 % (1987) to 34.6 % in 1999 
- in Ouagadougou: from 15.3 % (1988) to 7.8 % (1991) and 8.1 % (1994) 
- in Fada N’Gourma: from 5.0 % (1988 and 1990) to 60.0 % (1991) 
- in Koudougou: from 0 % to 20.8 % (1990) to 7.9 % (1991). In fact, the variations observed are very significant due to the limited number of insects tested.   It therefore seems that in vivo chloroquine-resistance is not as significative as it is in the neighbouring countries.

Table I – in vivo chloroquine-resistance in Burkina-Faso

Study SiteYearNb testedR%  reference
Bobo-Diou lasso198743130.736
Ouagadougou198852815.368
Banfora1988461226.168
Fada N’Gourma19882015.068
Gaoua19897945.168
Dédougou19896311.668
Dori199026311.568
Dori1990180060
Fada N’Gourma19902015.060
Koudougou199024520.868
Koudougou199070060
Zagthouli1990522344.260
Banfora1990431226.160
Ouagadougou19915147.893
Fada N’Gourma1991201260.097
Koudougou19916357.997

Dori

19912328.797

Zagthouli

1991421023.897
Zagthouli199134411.897
Banfora1991441534.197
Dedougou199130310.097
Ouahigouya1991411126.897
Kossodo19913313.097
Tanghin1991360097
Prov.Oubritenga1992430097
Ouagadougou19948678.1103
Bobo-Dioulasso1999461634.8148
Prov. Houet20024558318.2180
Nord-Ouest20031201210.0189


In vitro: a study carried out in 1987 on 60 strains from Bobo-Dioulasso did not evidence any resistance (35). 
In 1983, D. Baudon et Coll. report one case of in vitro resistance out of 32 strains tested in Bobo-Dioulasso (15). This is probably the first known case in Burkina-Faso, one of the rare countries where the confirmation of the in vitro resistance (1983) preceded by several years that of the in vivo resistance (1987-1988). Two cases of in vivo resistance were confirmed in vitro in 1988 in the rural zone near Ouagadougou, and two other cases in urban zone in Bobo-Dioulasso (84). 
The other data are presented in table II. 

Table II – in vitro chloroquine-resistances in Burkina-Faso. 

Study SiteYearNb testedR%Reference
Bobo-Dioulasso19886158.2105
Bobo-Dioulasso1989611626.2105
Bobo-Dioulasso1990763140.8105
Bobo-Dioulasso199128725.0105
Ouagadougou199112216.763
Bobo-Dioulasso200162914.5174


Resistance to other antimalarial drugs This aspect has been the object a relatively few studies.   1. Amodiaquine: 
- 1987: absence of in vitro resistance in 39 strains in Bobo-Dioulasso (35) ; - 1992: absence of in vitro resistance in 19 strains in the Oubritenga Province (103) 
- 1999: in vivo study in Bobo-Dioulasso: 2 therapeutical failures out of 46 (4.3 %) (148).  P. Brasseur et Coll. Concluded to the efficacy of amodiaquine in Burkina Faso. 

2. Quinine: 
- 1987: absence of in vitro resistance in 24 strains in Bobo-Dioulasso (35). - 1992: absence of in vitro resistance in 19 strains in the Oubritenga Province (103). - 2001: 12 isolates out of 62 in vitro resistant ones in Bobo-Dioulasso (19.3 %) (174).   3. Mefloquine: The first failure of mefloquine-based prophylaxis was described in 1990; the strain is mefloquine-resistent in vitro, yet sensitive to chloroquine (58). A second case was reported in 1991 (Presse Med. 1991 ; 20 : 1738), then 5 new cases, in 1991 as well (69). 
In vitro in Bobo-Dioulasso: 
- in 1988, 1 resistant strain out of 45 tested = 2.2 % (105) 
- in 1989, 1 resistant strain out of 50 tested = 2.0 % (105) 
- in 1990, 5 resistant strains out of 69 tested = 7.2 % (105) 
- in 1991, 1 resistant strain out of 29 tested = 3.4 % (105) 
- in 2001, 15 resistant strains out of 69 tested = 24.2 % (174). 

In 1991, 16 Zagthouli strains were tested. No mefloquine-resistance was evidenced (93). 

4. Halofantrine: 
In 1994, a study of 74 patients did not lead to any therapeutic failure at D7, except 6 relapses at D14 (109). 

5. Sulfadoxine-pyrimethamine combination: 
In 1994, a study on 86 patients did not evidence any therapeutic failure at D7 or at D14 (110). Yet, in vitro, 1 resistant strain was identified out of 19 tested (5.3 %) (103). In 2002, 2 parasitologic resistances were evidenced out of 308 children treated (0.6 %) (180). 

6. Other antimalarial: 
No publication in the literature.
 The vectors and the antivectorial fight
Vectors

J. Hamon established an inventory in 1963.  Using human baits, he captured 4,515 mosquitos in the Bobo-Dioulasso region. The species are distributed as follows: Anopheles funestus (54.0 %), Anopheles gambiae (30.6 %), Anopheles nili (6.5 %), Anopheles coustani (4.7 %), Anopheles pharoensis (1.5 %), Anopheles flavicosta (1.2 %), Anopheles squamosus (0.4 %), Anopheles brohieri (0.2 %), Anopheles domicolus (0.2 %), Anopheles wellcomei (0.1 %) and Anopheles pretoriensis (0.04 %) (02). 

V. Robert et Coll. showed that Anopheles gambiae is frequent all year round in the rice field zone and in wooded savannah ; whereas Anopheles funestus is found only in wooded savannah, essentially during the dry season.  In the savannah, they counted 55 infectious bites per human per year (ib/h/year) during the dry season, and 133 ib/h/year during the rainy season.  In the rice culture zone, bites are spread over the whole year, with an average of 50 to 60 ib/h/year (18).

In Ouagadougou, the Anopheles gambiae dispersion is 1 to 1.5 km in town and 3 to 7 km in the surrounding countryside. Out of the 1,078 female anopheles captured, Anopheles gambiae represents 1,052 captures (97.6 %), Anopheles funestus 11 (1.0 %) and Anopheles pharoensis 15 (1.4 %)  (24). 

In the north-west Oudalan Province, there are no anopheles during the dry season, from March to June.  In September, the following species are captured: Anopheles gambiae s.l., Anopheles pharoensis, Anopheles rufipes and Anopheles coustani (39).

In the Kou valley, a rice growing areas, Anopheles gambiae represent 68.8 % of the captures on human baits, Anopheles pharoensis 25.5 %, Anopheles coustani 3.9 %, Anopheles funestus 1.7 % and Anopheles nili 0.1 %. The most productive larvae breeding sites are the rice crates (52).

J. Cabore shows that in the Sahelian zone, the Anopheles arabiensis predominates, whereas the Anopheles gambiae s.s. is present everywhere in the country during the rainy season and Anopheles funestus during the dry season (J. Cabore, comm. Pers.) 

The entomologic inoculation rate

This subject too has been well studied.
Il is lower than 1 ib/h/night in Ouagadougou (26).
Il is 244 to 418 ib/h/year in the south-west (40, 83), but only 2 ib/h/year near the airport of Bobo-Dioulasso (92). P. Gazin et Coll. recorded 4 ib/h/year in Bobo-Dioulasso (123).

Antivectorial fight

1. Numerous studies concern curtains and mosquito nets impregnated with remanent insecticides.

I 1987, G. Majori et Coll. show that in Ouagadougou the permethrine-impregnated curtains reduce by almost 100% the endophily of anopheles, with a persistence of the insecticide of about 1 year (33). 

For P. Carnevale et Coll. in Bobo-Dioulasso, the deltamethrine-impregnated mosquito nets reduce the transmission by 82 % and the pathological events by 59%.  Yet, the plasmodic index remains unchanged (49).

Y. Pietra et Coll. show that in rice fields, permethrine-impregnated curtains reduce by 99.5% the densities of Anopheles gambiae at rest inside houses, and by 83% the number of bites on human in the house, and this for at least two years (80). V. Robert et P. Carnevale showed that, in the Kou Valley, deltamethrine-impregnated mosquito nets reduce by 94 % in two years the number of ib/h/year (82).

A. Habluetzel et Coll. showed that impregnated mosquito nets are active not only against malaria. They lead to a 15 % reduction of mortality within 6-59 months, all etiologies combined (125).  But P.G. Procacci et Coll. demonstrated that at 23H30, 35 % of the inhabitants are still outside of the mosquito nets, which significantly reduces its efficacy (66).

N. Cuzin-Ouattara et Coll., D.A. Diallo et Coll., and then A. Habluetzel et Coll., have reported the results of a large scale trial on the impregnated curtains; 158 villages within a zone of about 1000 km2 have been equipped with curtains: in these villages, the entomologic inoculation rate was 11 ib/h/month.  It was 218 ib/h/moonth in the control villages (150. 151, 158).

Anophelian resistance to insecticides

In 1991, F. Darriet et Coll. studied 3 pyrethrinoids and did not evidence any resistance (67). 
In 1999, in the Kou valley, F. Chandre et Coll. showed a mortality rate of 29.2 % with permethrine, 95.2 % with deltemethrine and 67.3 % with DDT (162).  The same year, they showed the absence of the pyrethrinoids-resistance gene kdr in the Anopheles gambiae M (164). This gene was described for the first time in 2002 by A. Diabaté et Coll. (178).

 The Treatment of Malaria

In 1986, D. Baudon et Coll. showed that a chloroquine-based chemoprophylaxis in children age 0-9, reduces their plasmodic index from 51.9 % to 26.2 % during the rainy season, and from 38.4 % to 7.7 % during the dry season; moreover, they demonstrated that after one year of application, the interest of the families for this strategy drops significantly.  Consequently, they proposed a systematic treatment for any fever attack, by means of chloroquine at a dose of 10 mg/kg.  This is the first known publication on the presumptive treatment of malaria attacks (30).

In 1983, the Centre National de lutte contre le Paludisme (CNLP - National AntiMalaria Centre) was created. It is located in the ''Centre Muraz'' in Bobo-Dioulasso (132).
In 1992, the ''Programme National de Lutte contre le Paludisme (PNLP - National Anti Malaria Programme) was created, with its head office located in Ouagadougou (J. Caboré, comm. pers.). Address:
01 BP 2208 Ouagadougou 01, Burkina Faso
Tél : +226 32 45 95
Fax : +226 31 04 77

M. Cot et Coll. carried out an in-depth study on the action of malaria chemoprophylaxis in pregnant women.  They showed that when treated with chloroquine:
- the rate of infected placentas dropped from 19.0 % to 4.1 %
- the weight of the newborns did not significantly increase
- the rate of light weight newborns did not change
- the mother's hematocrite changes from 36.5 % to 37.4 %
- the frequency of anemia in mothers dropped from 8.3 % to 6.3 % (91, 139). 

The treatment of malaria has also been analyzed:

- The treatment of malaria in Burkinabe households absorbs 5 % of the budget (106).

- For 6 months, O. Müller et Coll. monitored - on a daily basis - 709 children age 6 to 31 months: 1,848 pathologic events were recorded, including 1,640 fever attacks (88.7 %) and 894 malaria attacks (48.4 % of the pathology and 54.5 % of fever attacks) ; 69 % of the children were treated at home, 16 % in the local health centre, 13 % in the village and 1 % at the hospital.  This choice being a function of the access to the health institution and of the severity of the disease.
By studying the history of the dead children, the authors noticed that the children with a clinical history of diarrhoea had received no treatment, whereas those who had a malaria history had all received an antimalarial treatment, albeit unsuitable.  The inadequacy of the treatment came from the fact that it was mainly a defective second line treatment when chloroquine had been inefficient (188).

- For G. Krauze et Coll., 21 % of the cases of malaria are examined in the health centre. A study of the files show that 69 % of the visiting patients received a full clinical examination and 81 % are prescribed a treatment with a correct posology; 91 % purchase the treatment and 68 % take it correctly. In total, the efficacious treatment of malaria in the community is assessed at only 3 % of malaria cases (167).

 Advices to travelers

P. Gazin insists on the reduction of the efficacy of chloroquine, which does not stop Europeans under prophylaxis from developing low level malaria crises, with deceiving symptomatology and low parasitemia (102).
Chloroquine alone in prophylaxis is no longer recommended.

According to the B.E.H. n°24-25 of the 14 june 2005, the ''Institut français de veille sanitaire'' places Burkina-Faso in the group 2 of "countries with  chloroquine-resistance " (195). This means that the recommended chemoprophylaxis is the Chloroquine + Proguanil combination or, as an alternative, the Atovaquone-Proguanil combination.

Simple measures of individual protection against anopheles bites should still be applied: skin repellent, and bed mosquito nets impregnated with persistent insecticide.

 Bibliography

The presence of the Muraz Centre and of its numerous researchers in Bobo-Dioulasso explains the high number and the quality of the publications dealing with malaria in Burkina-Faso. We have compiled almost 200 publications on the subject, most of them referenced. There are obviously more articles in the unreferenced scientific press and in the grey literature namely: reports, theses, essays etc.  For more information, refer directly to the Muraz Centre:
direction.muraz@fasonet.bf

01 - Jonchère H, Pfister R - Enquêtes malariologiques en Haute-Volta, Côte d'Ivoire et Guinée (janvier-mars 1951). Bull. Soc. Path. Ex. 1951; 44: 774-86.

02 - Hamon J - Etude de l'âge physiologique des femelles d'anophèles dans les zones traitées au DDT, et non traitées, de la région de Bobo Dioulasso, Haute Volta. Bull. WHO  1963; 28: 83-109.

03 - Lasch EE, N'Guyen TL - Observations on an apparent chloroquine-resistant strain of Plasmodium falciparum in West Africa. Brit. Med. J. 1965; 2: 1219-22.

04 - Jeffery GM, Gibson FD - Studies on chloroquine-resistance of Plasmodium falciparum in Upper Volta and Liberia, West Africa. Bull. WHO 1966; 35: 441-9.

05 - Pirame Y, Patacq-Croutzet J, Dujeu G, Sawadogo R - Résultats observés après une injection unique de sulphorméthoxine dans le traitement de l'accès palustre à Plasmodium falciparum à l'Hôpital de Ouagadougou (Haute-Volta). Bull. Soc. Path. Ex. 1968; 61: 389-92. 

06 - Coz J, Picq JJ, Ricossé JH - Sporogonie chez Anopheles gambiae "A" de souches de Plasmodium falciparum résistantes à la pyriméthamine. Bull. Soc. Path. Ex. 1970; 63: 201-8. 

07 - Davidson G - Une méthode de lutte génétique contre Anopheles gambiae Giles, 1902. Ann. Parasitol. Hum. Com. 1971 ; 46, 3 bis: 149-63. 

08 - Coz J, Picq JJ - Etude en laboratoire de la réceptivité à Laverania falcipara 
d'Anopheles gambiae A et d'Anopheles gambiae B. Bull. Soc. Path. Ex. 1972; 65: 668-75. 

09 - Richard-Lenoble D, Ricossé JH, Picq JJ - Etude sur le traitement du paludisme à Plasmodium falciparum dans la région de Bobo-Dioulasso, Haute-Volta. Bull. WHO  1973; 49: 149-54. 

10 - Foege WH, Hogan RC, Newton LH - Surveillance projects for selected diseases. Int. J. Epidemiol. 1976 ; 5 : 29-37.

11 - Amat-Roze JM, Remy G - Paysage épidémiologique du paludisme dans l'espace ivoiro-voltaïque. Med. Trop. 1982; 42: 383-92. 

12 - Monjour L, Trape JF, Druilhe P, Bourdillon F, Fribourg-Blanc A, Palminteri R, Gentilini M, Kyelem JM - Malaria and haptoglobin content of serum in a rural population in Upper Volta. Ann. Trop. Med. Parasitol. 1982 ; 76: 105-7.

13 - Monjour L, Bourdillon F, Schlumberger M , Fayet MT, Michon C, Ballet JJ, Gouba E, Gentilini M - Etude de l'immunité humorale et cellulaire après vaccination antitétanique chez l'enfant africain malnutri et paludéen. 1- Etude de la réponse en anticorps antitétaniques. Bull. WHO  1982; 60: 589-96. 

14 - Ballet JJ, Agrapart M, Monjour L, Bourdillon F, Karam M, Kyelem JM, Stoeckel P - Etude de l'immunité humorale et cellulaire après vaccination antitétanique chez l'enfant africain malnutri et paludéen. 2 - Etude in vitro des réponses cellulaires non spécifiques et spécifiques à l'anatoxine tétanique. Bull. WHO 1982; 60: 597-604. 

15 - Baudon D, Devoucoux R, Roux J, Sondo B - Etude de la sensibilité de Plasmodium falciparum à la chloroquine dans une zone de savane du Burkina Faso, ex Haute-Volta, à paludisme hyperendémique. Utilisation des tests in vivo et in vitro. Mise en évidence d'une souche résistante in vitro. Bull. Soc. Path. Ex. 1983; 76: 658-65. 

16 - Daniel-Ribeiro C, Alfred C, Monjour L, Gentilini M - Normal frequency of anti-thyroglobulin antibodies in hyperendemic areas of malaria: relevance to the understanding of autoantibody formation in malaria. Trop. Geogr. Med. 1984; 36: 323-8.

17 - Monjour L, Bourdillon F, Froment A, Daniel-Ribeiro C, Tirard S, Datry A, Chastang C, Tselentis Y, Gentilini M - Vaccination antirougeoleuse en Afrique soudano-sahélienne. Absence d'effet immunodépresseur du paludisme. Path. Biol. 1985; 33: 232-5. 

18 - Robert V, Gazin P, Boudin C, Molez JF, Ouedraogo V, Carnevale P - La transmission du paludisme en zone de savane arborée et en zone rizicole des environs de Bobo Dioulasso. Ann. Soc. belge Med. trop. 1985 ; 65 suppl. 2 : 201-14. 

19 - Baudon D, Gazin P, Rea D, Carnevale P - A study of malaria morbidity in a rural area of Burkina Faso (West Africa). Trans. R. Soc. Trop. Med. Hyg. 1985; 79: 283-4.

20 - Desgranges C, Ploton I, Paire J, Dubois P, Monjour L - Production d'anticorps monoclonaux humains dirigés contre différents antigènes des stades érythrocytaires de Plasmodium falciparum. C. R. Acad. Sc. Paris. 1985; 301, III: 219-24. 

21 - Gazin P, Robert V, Carnevale P - Etude longitudinale des indices paludologiques de deux villages de la région de Bobo Dioulasso (Burkina Faso). Ann. Soc. belge Med. trop. 1985 ; 65 suppl. 2 : 181-6.

22 - Lombardi S, Esposito F, Zavala F, Lamizana L, Rossi P, Sabatinelli G, Nussenzweig RS, Coluzzi M - CS antigen localization in malaria vectors : hypothetical refractoriness to transmission observed in the field. Parassitologia 1986; 28: 113-6.

23 - Esposito F, Lombardi S, Modiano D, Zavala F, Reeme J, Lamizana L, Coluzzi M, Nussenzweig RS - Immunity to Plasmodium sporozoites: recent advances and applications to field research. Parassitologia 1986; 28: 101-5.

24 - Sabatinelli G, Rossi P, Belli A - Etude sur la dispersion d'Anopheles gambiae s.l. dans une zone urbaine à Ouagadougou (Burkina Faso). Parassitologia 1986; 28: 33-9. 

25 - Sabatinelli G, Bosman A, Lamizana L, Rossi P - Prévalence du paludisme à Ouagadougou et dans le milieu rural limitrophe en période de transmission maximale. Parassitologia 1986; 28: 17-31. 

26 - Rossi P, Belli A, Mancini L, Sabatinelli G - Enquête entomologique longitudinale sur la transmission du paludisme à Ouagadougou (Burkina Faso). Parassitologia 1986; 28: 1-15. 

27 - Esposito F, Lombardi S, Touré YT, Zavala F, Coluzzi M - Field observations on the use of anti-sporozoite monoclonal antibodies for determination of infection rates in malaria vectors. Parassitologia 1986; 28: 69-77.

28 - Petrarca V, Petrangeli G, Rossi P, Sabatinelli G - Etude chromosomique d'Anopheles gambiae et Anopheles arabiensis à Ouagadougou (Burkina Faso) et dans quelques villages voisins. Parassitologia 1986 ; 28 : 41-61. (Abstract)

29 - Petrarca V, Petrangeli G, Rossi P, Sabatinelli G - Programma di lotta antimalarica a Ouagadougou (Burkina Faso): il complesso Anopheles gambiae nella città di Ouagadougou e villaggi limitrofi. Ann. Ist. Super. Sanità. 1986; 22: 189-91. 

30 - Baudon D, Roux J, Carnevale P, Rey JL, Meyran MB, Brandicourt O - Systematic chemotherapy of febrile cases: a substitute strategy for malaria control in rural areas of Africa. Trans. R. Soc. Trop. Med. Hyg. 1986; 80: 164.

31 - Baudon D, Gazin P, Sanou JM, Ouedraogo L, Guiguemdé TR, Carnevale P - Morbidité palustre en milieu rural au Burkina Faso. Etude de 526 accès fébriles. Med. Afr. Noire 1986 ; 33 : 767-76.

32 - Lombardi S, Esposito F, Zavala F, Lamizana L, Rossi P, Sabatinelli G, Nussenzweig RS, Coluzzi M - Detection and anatomical localization of Plasmodium falciparum circumsporozoite protein and sporozoites in the afrotropical malaria vector Anopheles gambiae s.l.  Am. J. Trop. Med. Hyg. 1987; 37: 491-4.

33 - Majori G, Sabatinelli G, Coluzzi M - Efficacy of permethrin-impregnated curtains for malaria vector control. Med. Vet. Entomol. 1987; 1: 185-92.

34 - Brandicourt O, Carnevale P, Baudon D, Molez JF, Gazin P, Danis M, Duflo B, Gentilini M - Influence de la chimioprophylaxie ou de la chimiothérapie par la chloroquine sur l'acquisition des anticorps fluorescents antipalustres en zone de savane. Ann. Soc. belge Med. trop. 1987 ; 67 : 17-22. 

35 - Le Bras J, Simon F, Ramanamirija JA, Calmel MB, Hatin I, Deloron P, Porte J, Marchais H, Clausse JL, Biaud JM, Sarrouy J, Guiguemdé TR, Carme B, Charmot G, Coulaud JP, Coulanges P - Sensibilité de Plasmodium falciparum aux quinoléines et stratégies thérapeutiques: comparaison de la situation en Afrique et à Madagascar entre 1983 et 1986. Bull. Soc. Path. Ex. 1987; 80: 477- 89. 

36 - Baudon D, Guiguemdé TR, Ouedraogo JB - Surveillance de la sensibilité de Plasmodium falciparum à la chloroquine en Afrique de l'Ouest: intérêt de l'utilisation de tests in vivo à 5 et 10 mg/kg. Bull. Soc. Path. Ex. 1987; 80: 469-76. 

37 - Gbary AR, Guiguemde TR, Ouedraogo JB, Baudon D, Douchet CJJ, Le Bras J, Breman J - L'O.C.C.G.E. et la surveillance de la chimiosensibilité de Plasmodium falciparum aux antipaludéens. Bull. Soc. Path. Ex. 1987; 80: 461-8. 

38 - Mosset F, Bertherat J, Le Tulzo Y, Sicard D, Lebras J, Brunet F, Baetz A, Lapierre J - Accès pernicieux mortel à Plasmodium falciparum chloroquinorésistant au retour du Burkina Faso : une observation. Presse Med. 1988; 17: 2087-8. 

39 - Gazin P, Robert V, Cot M, Simon J, Halna JM, Darriet F, Legrand D, Carnevale P, Ambroise-Thomas P - Le paludisme dans l'Oudalan, région sahélienne du Burkina Faso. Ann. Soc. belge Med. trop. 1988 ; 68 : 255-64. 

40 - Robert V, Carnevale P, Ouedraogo V, Petrarca V, Coluzzi M - La transmission du paludisme urbain dans un village de savane du sud-ouest du Burkina Faso. Ann. Soc. belge Med. Trop. 1988 ; 68 : 107-21. 

41 - Mancini L, Romi R - Capacité larvivore de Barbus pobeguini et possibilité d'utilisation dans la lutte contre Anopheles gambiae s.l. . Parassitologia 1988; 30: 271-7. 

42 - Bosman A, Sabatinelli G, Lamizana L - Further observations on chemoprophylaxis and prevalence of malaria using questionnaire data in urban and rural areas of Burkina Faso. Parassitologia 1988; 30: 257-62.

43 - Baudon D, Gazin P, Galaup B, Pellotier-Guinart E, Picq JJ - Fiabilité de l'examen clinique dans le diagnostic des fièvres palustres en zone d'endémie ouest-africaine. Med. Trop. 1988; 48: 123-126. 

44 - Monjour L, Bourdillon F, Korinek AM, Aubonnet-Laignel A, Brousse G, Gentilini M, Bayard P, Ballet JJ - Etude de l'immunité humorale, cinq ans après vaccination antitétanique, d'un groupe d'enfants africains paludéens et malnutris. Path. Biol. 1988; 36: 235-9. 

45 - Gazin P, Cot M, Robert V, Bonnet D - La perception du paludisme en Afrique au sud du Sahara. Ann. Soc. belge Med. trop. 1988; 68 : 1-3. 

46 - Gazin P, Cot M, Sana S, Halna JM, Pazart L, Legrand D, Boillot F, Robert V, Carnevale P - La part du paludisme dans les consultations d'un dispensaire sahélien. Ann. Soc. belge Med. trop. 1988; 68 : 15-24. 

47 - Contreras CE, Santiago JI, Jensen JB, Udeinya IJ, Bayoumi R, Kennedy DD, Druilhe P - RESA-IFA assay in Plasmodium falciparum malaria, observations on relationship between serum antibody titers, immunity, and antigenic diversity. J. Parasit. 1988; 74 : 129-34.

48 - Baudon D, Galaup B, Ouedraogo L, Gazin P - Une étude de la morbidité palustre en milieu hospitalier au Burkina Faso (Afrique de l'Ouest). Med. Trop. 1988; 48: 9-13. 

49 - Carnevale P, Robert V, Boudin C, Halna JM, Pazart L, Gazin P, Richard A, Mouchet J - La lutte contre le paludisme par des moustiquaires imprégnées de pyréthrinoïdes  au Burkina Faso. Bull. Soc. Path. Ex. 1988; 81: 832-46. 

50 - Gazin P, Robert V, Cot M, Carnevale P - Plasmodium falciparum incidence and patency in a high seasonal transmission area of Burkina Faso. Trans. R. Soc. Trop. Med. Hyg. 1988; 82: 50-5.

51 - Esposito F, Lombardi S, Modiano D, Zavala F, Reeme J, Lamizana L, Coluzzi M, Nussenzweig RS - Prevalence and levels of antibodies to the circumsporozoite protein of Plasmodium falciparum in an endemic area and their relationship to resistance against malaria infection. Trans. R. Soc. Trop. Med . Hyg. 1988; 82: 827-32.

52 - Robert V, Ouary B, Ouedraogo V, Carnevale P - Etude écologique des Culicidae adultes et larvaires dans une rizière en vallée du Ko