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May 6, 1983

Drug-resistant malaria raises concern, controversy

JAMA. 1983;249(17):2291-2296. doi:10.1001/jama.1983.03330410007004

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The unrelenting spread of resistance to drugs used for prophylaxis of Plasmodium falciparum malaria, the most virulent of the four species affecting humans, has become a focus of increasing concern, according to experts from the Centers for Disease Control (CDC) in Atlanta.

Reports to the annual meeting of the American Society for Tropical Medicine and Hygiene, held recently in Cleveland, indicate that Americans traveling to the East African countries of Kenya, Tanzania, Uganda, Madagascar, Mozambique, and the Comoro Islands are at particular risk for slipping through the veil of drug protection and acquiring the illness.

These findings prompted a recent revision of the CDC's recommended prophylaxis policy for P falciparum in visitors to these regions, according to Malaria Branch chief C. C. Kent Campbell, MD (MMWR 1982;31:No. 24 [June 25]). Despite the advisory, however, new cases of malaria among US travelers continue to be reported. (One pair of researchers has determined