malaria is a major public health problem with 300500 million new infections each year and an estimated 584,000 deaths from malaria were reported worldwide , with most ( 90% ) of the deaths occurring in africa . the decline of susceptibility of plasmodium falciparum to chloroquine and sulfadoxine - pyrimethamine in many high - transmission areas resulted in the change of drug use policy in africa . in democratic republic of congo ( drc ) , current recommendation therapy for severe malaria in drc is artemisinin - based combination therapy ( act ) ; mainly , artesunate - amodiaquine has been recommended formally as a first - line antimalarial regimen since 2005 . however , this policy is not controlled and the use of antimalarials without a prescription can have adverse effects on chemosensitivity in kinshasa , the drc . the aim of the present study was to assess the self - medication against malaria infection in population of congolese students living in kinshasa , drc . this cross - sectional study was carried out in university of kinshasa , kinshasa , drc . medical records of all students with malaria admitted to centre de sant universitaire ( csu ) of university of kinshasa from january 1 , 2008 , to april 30 , 2008 , were reviewed retrospectively . csu is a primary level centre located in the city of university of kinshasa , kinshasa , drc , and serving an estimated 30,000 students . students who experienced an episode of malaria and presented the following criteria , axillary temperature > 38.0c with positive plasmodium falciparum parasites in thick blood smears and absence of febrile conditions caused by diseases other than malaria , were included in this study . students who took an antimalarial malaria parasitaemia was confirmed with thick blood smears stained giemsa and examined for trophozoites of plasmodium falciparum . the following information was collected and analyzed : ( 1 ) age and gender and ( 2 ) nature , dosage , and duration of antimalarial treatment . statistical analysis was performed using the statistics software spss for windows ( 15.0 spss , chicago ) . data are represented as means  sd when the distribution was normal and median with range when the distribution was not normal . frequencies of different parameters of self - medication are expressed as proportions ( % ) . during the study period , 458 students had been admitted in our centre and 133 ( 29.0% ) had a diagnostic of malaria infection . the median age of the patients was 25.4 years ( range : from 18 to 36 years ) . self - medication was associated with the ingestion of artemisinin - based combination treatments ( acts ) in 14 cases ( 50% ) , sulfadoxine / pyrimethamine ( sp ) in 9 cases ( 32.1% ) , and quinine in 5 cases ( 19.9% ) . to our knowledge , the present study is the first attempt to examine the notion of self - medication with antimalarials drugs in a university of central africa . in kinshasa , malaria is highly endemic , stable with a perennial transmission . university of kinshasa is located in one of four districts of kinshasa , district of mont amba in the west region of this urban area . prevalence of anopheles gambiense was higher than that in other districts of the town [ 69 ] . in this report this high figure shows the existence of a gap in the health care system including the freedom to buy drugs without prescription in pharmacies . recent study in drc reported parasite genotyping which showed high frequencies of dihydrofolate reductase ( dhfr ) and dihydropteroate synthase ( dhps ) molecular sp - resistance markers , with 57% of the samples showing more than three mutations linked to sp resistance . self - medication with quinine was found in 20% of students . in national health care policy this rate is high for a molecule reserved for severe disease in congolese health care policy in management of malaria . a recent study supports our concerns and shows the appearance of an intermediate level of resistant forms to amino alcohols in the city of kinshasa compared with other areas of africa . in the drc however , with an important self - medication , surveillance of efficacy of these drugs becomes a necessity since here there are recent concerns that the efficacy of such therapies has declined on the thai - cambodian border . in our series , 50% of students used acts in self - medication . in comparison with our general population , fever treatment with acts another crucial health problem is counterfeit antimalarials , mainly act and sulfadoxine - pyrimethamine in developing countries as democratic republic of congo . this situation increases the risk of artemisinin and sp resistance developed by the use of subtherapeutic dosage of these drugs . self - medication remains an important public health problem in high school students of kinshasa . the recommendations of the national program against malaria are not sufficiently known in these communities . this should draw the attention of all partners involved in the fight against malaria in drc . the academic community should be a priority target for the information campaign about the disease and the dangers of self - medication and risk - taking counterfeit drugs . training and information actions must be reinforced for a better care of malaria and to preserve efficacy and safety of acts and quinine in drc .