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It has been complicated by the resistance to different antimalarial drugs, with a variable frequency and intensity depending on areas of transmission, according to a classification proposed by the WHO, these areas are classified in 3 categories, in relation to the frequency and the importance of the resistance to the antimalarial treatments.
In the areas of partial resistance and especially total resistance groups II and III, drug combinations of two antimalarial molecules are generally used, the type of chemoprophylaxis is therefore linked to the existence locally of resistance to various antimalarial drugs.
The length and conditions of the stay also play a role in large hotels or in out-of-the-way places, the age of patients a large number of antimalarial drugs are contra-indicated for young children, the existence of an eventual pregnancy, etc, the prescription of drugs therefore is subjected to a personalized consultation, by specialist doctors, and excludes any \'\' multi-purpose formula \'\'.
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In any event, it needs to be stressed that whatever type of chemoprophylaxis is prescribed, there is no guarantee of an infallible protection against malaria, malaria can be treated using different antimalarial drugs, which possess different mechanisms of action.
Unfortunately, over the years and due partly to incorrect use of the drugs in the field, resistance to antimalarial drugs has appeared, making certain treatments ineffective, fortunately, new molecules have been discovered and developed by researchers and the pharmaceutical industry.
The choice of treatment is based on the frequency of this resistance in the relevant area, and on the extent of any undesirable side effects caused by certain antimalarial drugs, to prevent the emergence of resistance to the most recent antimalarial drugs which are therefore the most powerful, the WHO in collaboration with the pharmaceutical industry, is actively examining the advantages of associating several antimalarial drugs that have different mechanisms of action and rapidity of action, the difficulty of the clinical atypical form and biological pauci-parasitic form diagnosis, among patients who have followed a chemoprophylaxis treatment, means sometimes hospitalization and a multiplication of the diagnostic examinations.
The presumptive treatment still remains a necessity at times, in endemic zones, more especially in Africa, the treatment is given following a clinical diagnosis, where the major symptom is a fever.
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