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Artemisinin combination therapies are the first-line treatments for uncomplicated Plasmodium falciparum malaria in most malaria-endemic countries. Recently, partial artemisinin-resistant P. falciparum malaria has emerged on the Cambodia-Thailand border. Exposure of the parasite population to artemisinin monotherapies in subtherapeutic doses for over 30 years, and the availability of substandard artemisinins, have probably been the main driving force in the selection of the resistant phenotype in the region. A multifaceted containment programme has recently been launched, including early diagnosis and appropriate treatment, decreasing drug pressure, optimising vector control, targeting the mobile population, strengthening management and surveillance systems, and operational research. Mathematical modelling can be a useful tool to evaluate possible strategies for containment.

Original publication

DOI

10.1038/nrmicro2331

Type

Journal article

Journal

Nat Rev Microbiol

Publication Date

04/2010

Volume

8

Pages

272 - 280

Addresses

Mahidol Oxford Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok10400, Thailand. arjen@tropmedres.ac

Keywords

Antimalarials, Artemisinins, Cambodia, Disease Outbreaks, Drug Resistance, Malaria, Falciparum, Plasmodium falciparum, Thailand