N. J. WhiteW. PongtavornpinyoMahidol UniversityJohn Radcliffe Hospital2018-07-242018-07-242003-03-07Proceedings of the Royal Society B: Biological Sciences. Vol.270, No.1514 (2003), 545-55414712970096284522-s2.0-0037423830https://repository.li.mahidol.ac.th/handle/20.500.14594/20643Antimalarial 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.Mahidol UniversityAgricultural and Biological SciencesBiochemistry, Genetics and Molecular BiologyEnvironmental ScienceImmunology and MicrobiologyConference PaperSCOPUS10.1098/rspb.2002.2241