Artemisinin resistance: current status and scenarios for containment

AM Dondorp, S Yeung, L White, C Nguon… - Nature Reviews …, 2010 - nature.com
AM Dondorp, S Yeung, L White, C Nguon, NPJ Day, D Socheat, L Von Seidlein
Nature Reviews Microbiology, 2010nature.com
Artemisinin combination therapies are the first-line treatments for uncomplicated
Plasmodium falciparum malaria in most malaria-endemic countries. Recently, partial
artemisinin-resistant P. falciparum malaria has emerged on the Cambodia–Thailand border.
Exposure of the parasite population to artemisinin monotherapies in subtherapeutic doses
for over 30 years, and the availability of substandard artemisinins, have probably been the
main driving force in the selection of the resistant phenotype in the region. A multifaceted …
Abstract
Artemisinin combination therapies are the first-line treatments for uncomplicated Plasmodium falciparum malaria in most malaria-endemic countries. Recently, partial artemisinin-resistant P. falciparum malaria has emerged on the Cambodia–Thailand border. Exposure of the parasite population to artemisinin monotherapies in subtherapeutic doses for over 30 years, and the availability of substandard artemisinins, have probably been the main driving force in the selection of the resistant phenotype in the region. A multifaceted containment programme has recently been launched, including early diagnosis and appropriate treatment, decreasing drug pressure, optimising vector control, targeting the mobile population, strengthening management and surveillance systems, and operational research. Mathematical modelling can be a useful tool to evaluate possible strategies for containment.
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