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Highlights: [•] Artemisinin resistance may be emerging. [•] Resistance is being viewed as a prolonged parasite clearance phenotype. [•] This phenotype may not tell the whole story. [•] Defining resistance rigorously is important and includes other key variables. [Copyright &y& Elsevier]

Chloroquine resistant malaria (CQR) emerged in East Africa during the late 1970s and then spread westward. A molecular marker only became available in the late 1990s, and by that time CQR had permeated throughout Africa. By contrast, resistance to sulphadoxine-pyrimethamine (SPR) has emerged during an era of molecular surveillance, and the changing prevalence of SPR conferred by point mutations in the dhfr and dhps genes has been recorded in hundreds of sites across Africa. We have collated and mapped reports of the dhps K540E mutation, a uniquely informative marker of SPR, and used these to describe the geography of its dispersal through time. Like CQR, dhps K540E appeared first in East Africa and spread west. We discuss whether there are common principles governing resistance dispersal in Africa and how these might guide surveillance in future. [ABSTRACT FROM AUTHOR]

As a major factor in Plasmodium falciparum malaria pathogenesis, the var gene family has been the focus of extensive research, which has contributed to our current understanding of Plasmodium antigenic variation. In recent years, sophisticated molecular tools have enabled the generation of interesting data regarding the regulation of mutually exclusive var expression. Although their results are still inconclusive, these studies have demonstrated the existence of multiple layers of control over gene activation, silencing, memory and ‘counting’. This review attempts to summarize recent findings and dissect the different layers of var regulation. [Copyright &y& Elsevier]

Highlights: [•] Published parasite clearance curves are interpreted by artemisinin derivatives. [•] Current knowledge in artemisinin resistance towards sustainable combination therapies (ACT) is integrated. [•] Efficacy of partner drugs used in ACTs is crucial for its efficacy. [Copyright &y& Elsevier]