Publication: The de novo selection of drug-resistant malaria parasites
Issued Date
2003-03-07
Resource Type
ISSN
14712970
09628452
09628452
Other identifier(s)
2-s2.0-0037423830
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Mahidol University
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SCOPUS
Bibliographic Citation
Proceedings of the Royal Society B: Biological Sciences. Vol.270, No.1514 (2003), 545-554
Suggested Citation
N. J. White, W. Pongtavornpinyo The de novo selection of drug-resistant malaria parasites. Proceedings of the Royal Society B: Biological Sciences. Vol.270, No.1514 (2003), 545-554. doi:10.1098/rspb.2002.2241 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/20643
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Title
The de novo selection of drug-resistant malaria parasites
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Abstract
Antimalarial drug resistance emerges de novo predominantly in areas of low malaria transmission. Because of the logarithmic distribution of parasite numbers in human malaria infections, inadequately treated high biomass infections are a major source of de novo antimalarial resistance, whereas use of antimalarial prophylaxis provides a low resistance selection risk. Slowly eliminated antimalarials encourage resistance largely by providing a selective filter for resistant parasites acquired from others, and not by selecting resistance de novo. The de novo emergence of resistance can be prevented by use of antimalarial combinations. Artemisinin derivative combinations are particularly effective. Ensuring adequate treatment of the relatively few heavily infected patients would slow the emergence of resistance.