How to Contain Artemisinin- and Multidrug-Resistant Falciparum Malaria. Issue 5 (May 2017)

• Record Type: Journal Article
• Authors: Dondorp, Arjen M.; Smithuis, Frank M.; Woodrow, Charley; Seidlein, Lorenz von
• Is Part Of: Trends in parasitology. Volume 33:Issue 5(2017:May)
• Page Start: 353
• Page End: 363
• Publication Date: 2017-05
• Subjects: Falciparum malaria -- artemisinin and multi-drug resistance -- Greater Mekong subregion -- containment -- malaria elimination; Parasitology -- Periodicals; Parasitology -- Periodicals; Biology -- Periodicals; Parasitology; Biology; Parasitologie -- Périodiques; Online resources; 571.999
• DOI: 10.1016/j.pt.2017.01.004
• Languages: English
• ISSNs: 1471-4922

Abstract

Abstract : In the Greater Mekong subregion (GMS), artemisinin resistance is increasingly compounded by partner drug resistance, causing high failure rates of artemisinin combination therapies in some areas. For its containment, an accelerated elimination strategy will be needed. This includes high-quality implementation of conventional malaria control measures: early case management with quality artemisinin combination therapies (avoiding artesunate monotherapies) and single gametocytocidal low dose of primaquine, vector control and surveillance. Village health workers (VHWs) play a key role in the provision of community-based services which have to reach even the most remote populations. Additional, more aggressive, approaches will be important to accelerate malaria elimination, which could include mass drug administrations, potentially in combination with ivermectin and vaccination, mass screening and treatment with novel diagnostics, reactive case detection, and other measures. Trends: Artemisinin resistance in falciparum malaria is now widespread in the Greater Mekong subregion (GMS) and has selected for partner drug resistance causing high treatment failure of artemisinin combination therapies (ACTs) in increasing areas of the GMS. Current containment and malaria elimination projects have substantially reduced the malaria burden in the region, but have not halted expansion of drug resistance. There is convergence of opinions that quality implementation of malaria-control measures reaching remote populations at risk is essential for malaria elimination, whereas the additional tools needed to accelerate malaria elimination for containment of multidrug-resistant falciparum malaria are still a matter of debate.