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1
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Monitoring and Deterring Drug-Resistant Malaria in the Era of Combination Therapy
Miriam K. Laufer
Miriam K. Laufer
Malaria Section, Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, Maryland; Malaria Research and Training Center, Department of Epidemiology of Parasitic Diseases, Faculty of Medicine, Pharmacy, and Dentistry, University of Bamako, Bamako, Mali
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Abdoulaye A. Djimdé
Abdoulaye A. Djimdé
Malaria Section, Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, Maryland; Malaria Research and Training Center, Department of Epidemiology of Parasitic Diseases, Faculty of Medicine, Pharmacy, and Dentistry, University of Bamako, Bamako, Mali
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Christopher V. Plowe
Christopher V. Plowe
Malaria Section, Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, Maryland; Malaria Research and Training Center, Department of Epidemiology of Parasitic Diseases, Faculty of Medicine, Pharmacy, and Dentistry, University of Bamako, Bamako, Mali
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As chloroquine and sulfadoxine-pyrimethamine (SP) are replaced by more effective artemisinin-based combination therapies (ACTs), strategies for monitoring (and, if possible, deterring) drug-resistant malaria must be updated and optimized. In vitro methods for measuring resistance will be critical for confirming and characterizing resistance to ACTs. Molecular markers are useful for tracking the emergence and dissemination of resistance and guiding treatment policy where resistance is low or moderate. Genomic approaches may help identify molecular markers for resistance to artemisinins and their partner drugs. Studies of reported ACT treatment failure should include assessing factors other than resistance that affect efficacy, including pharmacokinetics. Longitudinal clinical trials are particularly useful for comparing the benefits and risks of repeated treatment in high transmission settings. The malaria research and control community should not fail to exploit this opportunity to apply the lessons of the last 50 years to extend the useful therapeutic lives of ACTs.
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1
Rieckmann KH, McNamara JV, Frischer H, Stockert TA, Carson PE, Powell RD, 1968. Effects of chloroquine, quinine, and cycloguanil upon the maturation of asexual erythrocytic forms of two strains of Plasmodium falciparum in vitro. Am J Trop Med Hyg 17 :661–671.
-
2
Nguyen-Dinh P, Payne D, 1980. Pyrimethamine sensitivity in Plasmodium falciparum: determination in vitro by a modified 48-hour test. Bull World Health Organ 58 :909–912.
-
3
Plowe CV, 2003. Monitoring antimalarial drug resistance: making the most of the tools at hand. J Exp Biol 206 :3745–3752.
-
4
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-
5
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-
6
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-
7
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