At the turn of this new century and after much debate, the malaria community reckoned with failing first line therapies and moved to a global recommendation for deployment of an artemisinin-based combination therapy (ACT) to treat infections due to Plasmodium falciparum.
artemisinin-based combination therapy (ACT)
DHA–PPQ is an efficacious ACT and candidate for replacement of first-line treatment in Sudan while AS/SP showed high treatment failure rate and must be replaced.
The implementation of ACT has led to the decline in prevalence of chloroquine-resistant parasites in the Republic of Congo.
Anti-malarial drug resistance to chloroquine and sulfadoxine–pyrimethamine has spread from Southeast Asia to Africa.
The efficacy of AL, AS + MQ and DP remains high in northern Myanmar despite widespread evidence of k13 mutations associated with delayed parasite clearance.
The establishment of a reduced susceptibility to monodesethylamodiaquine as well as chloroquine resistance, and the emergence of a reduced susceptibility to doxycycline are disturbing.
Popular anti-malarial HPs used in southern Ghana were found to have chemo-suppressive properties.
A combined subsidy on both RDT and ACT rather than a single subsidy is likely required to improve diagnosis-treatment behaviour among individuals seeking care for malaria in the private sector.
The emergence in 2009 of Plasmodium falciparum parasites resistant to the primary therapies currently in use (artemisinin-based combination therapy, ACT) in Southeast Asia threatens to set back decades of global progress in malaria control and elimination.
This case confirms the risk of therapeutic failure with dihydroartemisinin–piperaquine by under-dosing in patients weighing more than 100 kg.