Simple jQuery Dropdowns
Please use this identifier to cite or link to this item: http://repository.li.mahidol.ac.th/dspace/handle/123456789/27724
Title: The last man standing is the most resistant: Eliminating artemisinin-resistant malaria in Cambodia
Authors: Richard J. Maude
Wirichada Pontavornpinyo
Sompob Saralamba
Ricardo Aguas
Shunmay Yeung
Arjen M. Dondorp
Nicholas Pj Day
Nicholas J. White
Lisa J. White
Mahidol University
Nuffield Department of Clinical Medicine
Instituto Gulbenkian de Ciencia
London School of Hygiene & Tropical Medicine
Keywords: Immunology and Microbiology;Medicine
Issue Date: 1-Apr-2009
Citation: Malaria Journal. Vol.8, No.1 (2009)
Abstract: Background. Artemisinin combination therapy (ACT) is now the recommended first-line treatment for falciparum malaria throughout the world. Initiatives to eliminate malaria are critically dependent on its efficacy. There is recent worrying evidence that artemisinin resistance has arisen on the Thai-Cambodian border. Urgent containment interventions are planned and about to be executed. Mathematical modeling approaches to intervention design are now integrated into the field of malaria epidemiology and control. The use of such an approach to investigate the likely effectiveness of different containment measures with the ultimate aim of eliminating artemisinin-resistant malaria is described. Methods. A population dynamic mathematical modeling framework was developed to explore the relative effectiveness of a variety of containment interventions in eliminating artemisinin-resistant malaria in western Cambodia. Results. The most effective intervention to eliminate artemisinin-resistant malaria was a switch of treatment from artemisinin monotherapy to ACT (mean time to elimination 3.42 years (95% CI 3.32-3.60 years). However, with this approach it is predicted that elimination of artemisinin-resistant malaria using ACT can be achieved only by elimination of all malaria. This is because the various forms of ACT are more effective against infections with artemisinin-sensitive parasites, leaving the more resistant infections as an increasing proportion of the dwindling parasite population. Conclusion. Containment of artemisinin-resistant malaria can be achieved by elimination of malaria from western Cambodia using ACT. The "last man standing" is the most resistant and thus this strategy must be sustained until elimination is truly achieved.
URI: https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=63149179142&origin=inward
http://repository.li.mahidol.ac.th/dspace/handle/123456789/27724
ISSN: 14752875
Appears in Collections:Scopus 2006-2010

Files in This Item:
There are no files associated with this item.


Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.