Artemisinin resistance in malaria

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One of the infections with the biggest drug resistance problem is malaria. Already, there are chloroquine-resistant strains of malaria in most of the areas where malaria is endemic and there are areas where falciparum is resistant to all the major drugs other than the artemisins. Now, Jambou et al. report in the Lancet that they have found artemisinin-resistant parasites.

This is particularly depressing because (1) artemisinin therapy outside of China is relatively new (about a decade) and (2) there had been hopes that resistance would be slow to develop (see, for instance this Wikipedia article):

The drug is used these days in China and Vietnam without much regard to taking precautions against creating resistance of the malaria parasite to this drug as well, but nevertheless no resistance has been encountered in these parts of the world. Because ot the method of action, it is unlikely that resistance to artemisinine and derivatives will become a problem in the near future.

This reinforces the importance of using artemisinin as part of a combination therapy rather than a monotherapy. That and wearing insect repellent.

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