[Plasmodium falciparum resistant to sulfadoxine/pyrimethamine in Senegal]. / Plasmodium falciparum resistente a sulfadoxina/pirimetamina en el Senegal.

In 1983, the first African cases of malaria due to Plasmodium falciparum resistant to sulfadoxine/pyrimethamine, were described. Currently, this resistance is frequently found in Kenya and Tanzania. It has also been described in other African countries. A young Spanish woman contracted Plasmodium falciparum malaria in Senegal and was treated in our hospital with sulfadoxine/pyrimethamine. Fever and symptoms disappear within two days. The thick smears taken on the eighth and thirteenth days of treatment contained an abundance of gametocytes, but neither trophozoites nor schizonts. As the risk of transmission of malaria to the rest of the community was considered practically nil, no other treatment was administered. A month late, she was admitted to the hospital due to fever, shivering, fatigue, loss of appetite and hemolytic anaemia. The thick smear test again showed trophozoites of P. Falciparum. Thus, it proved to be a delayed grade I resistance to sulfadoxine/pyrimethamine, detected in far west Africa. An oral dose of mefloquine was administered as well as a red cell transfusion. Both fever and symptoms finally disappeared.

A comparative study of the RAST, indirect haemagglutination, basophil degranulation and latex tests in the diagnosis of human hydatid disease.

In order to compare the diagnostic efficacy of the, basophil degranulation, RAST, indirect haemagglutination and latex tests, we carried out these four tests on 50 patients with confirmed hydatid disease due to Echinococcus granulosus. As a control group we employed 50 subjects who showed no evidence of hydatid disease or any other parasitic disease. The test which displayed the highest degree of diagnostic efficacy was the basophil degranulation test with a sensitivity of 93% and an accuracy of 97%. Next in diagnostic efficacy were the haemagglutination and RAST tests with very similar results-a sensitivity of 82% and an accuracy of 91% for the former, and for the latter a sensitivity of 80% and an accuracy of 90%. The latex test, with a sensitivity of 67% and an accuracy of 83%, possessed the lowest degree of diagnostic efficacy. There is an obvious decrease in the sensitivity of the tests when the localization of the cyst exclusively pulmonary; in these cases the RAST test was positive in only 50%, and the degranulation test in 77.7%.