Publication: Artemisinin and multidrug-resistant Plasmodium falciparum - a threat for malaria control and elimination
Issued Date
2021-10-01
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ISSN
14736527
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2-s2.0-85116958759
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Mahidol University
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SCOPUS
Bibliographic Citation
Current opinion in infectious diseases. Vol.34, No.5 (2021), 432-439
Suggested Citation
Mehul Dhorda, Chanaki Amaratunga, Arjen M. Dondorp Artemisinin and multidrug-resistant Plasmodium falciparum - a threat for malaria control and elimination. Current opinion in infectious diseases. Vol.34, No.5 (2021), 432-439. doi:10.1097/QCO.0000000000000766 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/77805
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Title
Artemisinin and multidrug-resistant Plasmodium falciparum - a threat for malaria control and elimination
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Abstract
PURPOSE OF REVIEW: Artemisinin-based combination therapies (ACTs) are globally the first-line treatment for uncomplicated falciparum malaria and new compounds will not be available within the next few years. Artemisinin-resistant Plasmodium falciparum emerged over a decade ago in the Greater Mekong Subregion (GMS) and, compounded by ACT partner drug resistance, has caused significant ACT treatment failure. This review provides an update on the epidemiology, and mechanisms of artemisinin resistance and approaches to counter multidrug-resistant falciparum malaria. RECENT FINDINGS: An aggressive malaria elimination programme in the GMS has helped prevent the spread of drug resistance to neighbouring countries. However, parasites carrying artemisinin resistance-associated mutations in the P. falciparum Kelch13 gene (pfk13) have now emerged independently in multiple locations elsewhere in Asia, Africa and South America. Notably, artemisinin-resistant infections with parasites carrying the pfk13 R561H mutation have emerged and spread in Rwanda. SUMMARY: Enhancing the geographic coverage of surveillance for resistance will be key to ensure prompt detection of emerging resistance in order to implement effective countermeasures without delay. Treatment strategies designed to prevent the emergence and spread of multidrug resistance must be considered, including deployment of triple drug combination therapies and multiple first-line therapies.