Artemisinin resistance: the clock is tickingArchived
Artemisinin resistance in falciparum malaria has emerged in western Cambodia exactly where chloroquine resistance arose 50 years ago. Similarly to the resistance to chloroquine that spread to Africa, the experts are wondering whether artemisinin resistance will spread as widely. In such a case the consequences would be disastrous.
Nicholas J WhiteLancet 2010; 376 : 2051- 2052
Description: Artemisinin resistance in falciparum malaria has emerged in western Cambodia exactly where chloroquine resistance arose 50 years ago. Similarly to the resistance to chloroquine that spread to Africa, the experts are wondering whether artemisinin resistance will spread as widely. In such a case the consequences would be disastrous. No-one knows today if artemisinin-resistant parasites will spread westward to India and Africa. In addition, we do not understand the molecular mechanisms underlying artemisinin resistance. And we do not know if these artemisinin-resistant malaria parasites could spread beyond Southeast Asia and establish themselves in other human populations.
Public Health significance: Drug resistance may arise from inadequate or inappropriate use of anti-infectives. Artemisinin resistance has emerged in falciparum malaria in limited areas of Southeast Asia. One important clue for prevention of this resistance is to avoid the use of artesunate derivates as monotherapy. This information should be taken into account for disease surveillance, strategic planning and formulation of policy guidelines. Limiting the spread of this resistance beyond the Thai borders is a key issue. The author of the editorial estimates that it would be prudent to expect the worst even assuming this global threat might still be preventable.