Assessment of clinical course and outcome of Plasmodium falciparum malaria in Angola diagnosed by microscopic and molecular methods.

Malaria still remains the main infectious cause of morbidity and mortality in the world. The majority of cases occur in tropical Africa, including Angola. The study was performed in Angola, in the Health Centre of St. Lucas in Kifangondo, near Luanda during the dry season, from May to October 1999. 168 patients with symptoms of malaria were referred for study enrolment. In the study we assessed the efficacy of treatment in falciparum malaria based on clinical, microscopic and polymerase chain reaction (PCR) examination, and estimated the prevalence of mutations in the pfcrt gene in the P. falciparum isolates from chloroquine-treated patients. In 159 (95%) patients P. falciparum malaria was diagnosed using microscopic methods. This was confirmed by PCR. We admitted 68 patients to the hospital; 13 patients died from complicated malaria. We have analysed 59 cases of P. falciparum malaria known to be chloroquine-treated. In 58 (98%) cases we have found P. falciparum isolates that carried gene polymorphisms typical for chloroquine resistance. In the group with such P. falciparum isolates, 8 people were treated successfully. Reasons for this response are discussed.