HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Similar articles in this journal Similar articles in ISI Web of Science Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (1) Google Scholar Articles by Laufer, M. K. Articles by Plowe, C. V. PubMed Articles by Laufer, M. K. Articles by Plowe, C. V.

Monitoring and Deterring Drug-Resistant Malaria in the Era of Combination Therapy

As chloroquine and sulfadoxine-pyrimethamine (SP) are replaced by more effective artemisinin-based combination therapies (ACTs), strategies for monitoring (and, if possible, deterring) drug-resistant malaria must be updated and optimized. In vitro methods for measuring resistance will be critical for confirming and characterizing resistance to ACTs. Molecular markers are useful for tracking the emergence and dissemination of resistance and guiding treatment policy where resistance is low or moderate. Genomic approaches may help identify molecular markers for resistance to artemisinins and their partner drugs. Studies of reported ACT treatment failure should include assessing factors other than resistance that affect efficacy, including pharmacokinetics. Longitudinal clinical trials are particularly useful for comparing the benefits and risks of repeated treatment in high transmission settings. The malaria research and control community should not fail to exploit this opportunity to apply the lessons of the last 50 years to extend the useful therapeutic lives of ACTs.

Received January 17, 2007. Accepted for publication April 2, 2007.

Acknowledgments: The authors thank Malcolm Molyneux for helpful discussions and suggestions to improve the manuscript. CVP is supported by a Distinguished Clinical Scientist Award from the Doris Duke Charitable Foundation.

^* Address correspondence to Christopher V. Plowe, Center for Vaccine Development, University of Maryland School of Medicine, 685 W. Baltimore Street, HSF-1 Room 480, Baltimore, MD 21201. E-mail: cplowe{at}medicine.umaryland.edu

Authors’ addresses: Miriam K. Laufer and Christopher V. Plowe, Center for Vaccine Development, University of Maryland School of Medicine, 685 W. Baltimore Street, HSF-1 Room 480, Baltimore, MD 21201, Telephone: 410–706–5328, Fax: 410–706–1204, E-mails: mlaufer{at}medicine.umaryland.edu and cplowe{at}medicine.umaryland.edu. Abdoulaye A. Djimdé, Malaria Research and Training Center, Department of Epidemiology of Parasitic Diseases, Faculty of Medicine, Pharmacy and Dentistry, University of Bamako, Point G, BP 1805, Bamako, Mali, Telephone/Fax: 223–222–1809, E-mail: adjimde{at}mrtcbko.org.

This article has been cited by other articles:

				J. G. Breman, M. S. Alilio, and N. J. White Defining and Defeating the Intolerable Burden of Malaria III. Progress and Perspectives Am J Trop Med Hyg, December 1, 2007; 77(6_Suppl): vi - xi. [Full Text] [PDF]