[Mass chemoprophylaxis of malaria, its objectives, its limits, its difficulties]

In intertropical Africa, insecticide spreadings cannot succeed by themselves in controlling malarial endemia. They cannot provide any eradication, even if they are combined with chemoprophylaxis. On the other hand, mass chemoprophylaxis should provide a control of lethality and morbidity due to malaria. The authors define the mass prophylaxis concept, lay its basic principles and specifically the criteria used to select the available anti-malarial drugs. Then, they stress on the major set-backs such as P. falciparum resistance to amino-4-quinoleine, and drop of immunity in individuals receiving no chemoprophylaxis. Finally, they review the necessary conditions for the achievement of a mass chemoprophylaxis at a wide country level, namely: a determined policy with long term budget allowances, setting up of a specific organization and personnel training, community education at all levels, preliminary epidemiological surveys and strategical schemes suited to the various epidemiological patterns.