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Increasing resistance of Plasmodium falciparum malaria to antimalarial drugs is posing a major threat to the global effort to "Roll Back Malaria". Chloroquine and sulfadoxine-pyrimethamine (SP) are being rendered increasingly ineffective, resulting in increasing morbidity, mortality, and economic and social costs. One strategy advocated for delaying the development of resistance to the remaining armory of effective drugs is the wide-scale deployment of artemisinin-based combination therapy. However, the cost of these combinations are higher than most of the currently used monotherapies and alternative non-artemisinin-based combinations. In addition, uncertainty about the actual impact in real-life settings has made them a controversial choice for first-line treatment. The difficulties in measuring the burden of drug resistance and predicting the impact of strategies aimed at its reduction are outlined, and a mathematical model is introduced that is being designed to address these issues and to clarify policy options.

Original publication

DOI

10.4269/ajtmh.2004.71.179

Type

Journal article

Journal

The American journal of tropical medicine and hygiene

Publication Date

08/2004

Volume

71

Pages

179 - 186

Addresses

Wellcome Trust-Mahidol University-Oxford Tropical Medicine Research Program, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand. shunmay.yeung@lshtm.ac.uk, shunmay@hotmail.com

Keywords

Humans, Malaria, Sesquiterpenes, Artemisinins, Antimalarials, Drug Therapy, Combination, Drug Resistance, Multiple, Models, Theoretical