WHITE NJ; Interscience Conference on Antimicrobial Agents and Chemotherapy (43rd: 2003: Chicago, Ill.).
Abstr Intersci Conf Antimicrob Agents Chemother Intersci Conf Antimicrob Agents Chemother. 2003 Sep 14-17; 43: abstract no. 588.
Mahidol Univ., Bangkok, Thailand.
The global mortality from malaria is rising as a direct result of worsening drug resistance in Plasmodium falciparum. The widespread and uncontrolled use of inexpensive antimalarial drugs over the past 50 years has provided a tremendous selection pressure on human malaria parasite populations. Resistance has emerged in P. falciparum to all classes of antimalarial drugs except the artemisinin derivatives. The most widely used antimalarial chloroquine, is now partially or completely ineffective in most malaria affected countries. The usual successor is sulfadoxine-pyrimethamine, but high level resistance to this antifol combination often develops within five years of use. P.vivax has also developed resistance to antifols, and more recently in a few areas, to chloroquine. The emergence of drug resistance can be slowed or prevented altogether by the use of combinations of antimalarial drugs with different modes of action. This simple principle underlines the current recommendations for TB, HIV-AIDS, leprosy, and many cancers. The Chinese plant derived artemisinin derivatives are the most effective antimalarial drugs. Combinations with other classes of antimalarial drugs (ACTs) have proved highly effective and well-tolerated in extensive trials and operational use. The world's most drug resistant malaria parasites are found on the northwestern border of Thailand. By 1994 mefloquine resistance had reached 50%. Since then the systematic deployment of ACTs has led to a ninefold reduction in the incidence of falciparum malaria and a sustained reversal of drug resistance. Similar approaches are now being taken throughout South-East Asia, large clinical trials have been completed in Africa, and large scale implementation studies are underway. It is hoped that this general strategy can now be deployed throughout the malaria affected countries of the world and contribute to rolling back malaria.
Publication Types:
Keywords:
- Africa
- Animals
- Antimalarials
- Artemisinins
- Asia, Southeastern
- Chloroquine
- Drug Resistance
- Humans
- Incidence
- Malaria
- Malaria Vaccines
- Malaria, Falciparum
- Mefloquine
- Plasmodium falciparum
- Pyrimethamine
- Sulfadoxine
- Thailand
- artemisinine
- sulfadoxine-pyrimethamine
Other ID:
UI: 102265414
From Meeting Abstracts