1921
Volume 101, Issue 6
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645
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Abstract

Abstract.

In this review, we provide an epidemiological history of the emergence and ongoing spread of evolving artemisinin resistance (ARTR). Southeast Asia has been the focal point for emergence and spread of multiple antimalarial drug resistance phenomena, and is once again for evolving ARTR, also known as the “delayed clearance phenotype” (DCP). The five countries most impacted, Cambodia, Thailand, Myanmar, Laos, and Vietnam, each have complex histories of antimalarial drug use over many decades, which have in part molded the use of various artemisinin combination therapies (ACTs) within each country. We catalog the use of ACTs, evolving loss of ACT efficacy, and the frequency of mutations (mutations associated with ARTR) in the Greater Mekong Subregion and map the historical spread of ARTR/DCP parasites. These data should assist improved surveillance and deployment of next-generation ACTs.

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  • Received : 15 May 2019
  • Accepted : 06 Sep 2019
  • Published online : 21 Oct 2019

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