1. Plasmodium falciparum resistance to artemisinin-based combination therapies: A sword of Damocles in the path toward malaria elimination.
- Author
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Ouji M, Augereau JM, Paloque L, and Benoit-Vical F
- Subjects
- Africa South of the Sahara epidemiology, Antimalarials pharmacology, Artemisinins administration & dosage, Artemisinins adverse effects, Artemisinins pharmacology, Asia epidemiology, Asia, Southeastern epidemiology, Cambodia epidemiology, Clinical Trials as Topic, Disease Eradication legislation & jurisprudence, Disease Eradication methods, Humans, Malaria drug therapy, Malaria epidemiology, Malaria parasitology, Malaria, Falciparum epidemiology, Malaria, Falciparum parasitology, Antimalarials therapeutic use, Artemisinins therapeutic use, Drug Resistance, Multiple, Drug Therapy, Combination adverse effects, Malaria, Falciparum drug therapy, Plasmodium falciparum drug effects
- Abstract
The use of artemisinin-based combination therapies (ACTs), which combine an artemisinin derivative with a partner drug, in the treatment of uncomplicated malaria has largely been responsible for the significant reduction in malaria-related mortality in tropical and subtropical regions. ACTs have also played a significant role in the 18% decline in the incidence of malaria cases from 2010 to 2016. However, this progress is seriously threatened by the reduced clinical efficacy of artemisinins, which is characterised by delayed parasitic clearance and a high rate of recrudescence, as reported in 2008 in Western Cambodia. Resistance to artemisinins has already spread to several countries in Southeast Asia. Furthermore, resistance to partner drugs has been shown in some instances to be facilitated by pre-existing decreased susceptibility to the artemisinin component of the ACT. A major concern is not only the spread of these multidrug-resistant parasites to the rest of Asia but also their possible appearance in Sub-Saharan Africa, the continent most affected by malaria, as has been the case in the past with parasite resistance to other antimalarial treatments. It is therefore essential to understand the acquisition of resistance to artemisinins by Plasmodium falciparum to adapt malaria treatment policies and to propose new therapeutic solutions., (© M. Ouji et al., published by EDP Sciences, 2018.)
- Published
- 2018
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