1921
Volume 102, Issue 3
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645
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Abstract

Abstract.

The emergence of artemisinin-resistant in the Greater Mekong Subregion threatens both the efficacy of artemisinin-based combination therapy (ACT), the first-line treatment for malaria, and prospects for malaria elimination. Monitoring of ACT efficacy is essential for ensuring timely updates to elimination policies and treatment recommendations. In 2014–2015, we assessed the therapeutic efficacies of artemether–lumefantrine (AL) and dihydroartemisinin–piperaquine (DP) for the treatment of uncomplicated at three study sites in Rakhine, Shan, and Kachin states in Myanmar. Patients presenting with uncomplicated malaria were enrolled, treated, and followed up for 28 days for AL or 42 days for DP. Both AL and DP demonstrated good therapeutic efficacy at all three study sites. The 28-day cure rate for AL was > 96% across all study sites, and the 42-day cure rate for DP was 100%. Parasitemia on day 3 was detected in 0%, 3.3%, and 3.6% of participants treated with AL at the Rakhine, Shan, and Kachin sites, respectively. No participants treated with DP were parasitemic on day 3. No evidence of mutations was found at the Rakhine study site. A high prevalence of mutations associated with artemisinin resistance was observed at the Kachin and Shan state study sites. These results confirm that ACT efficacy has been resilient in therapeutic efficacy study (TES) sentinel sites in Myanmar, despite the presence at some sites of mutations associated with resistance. Studies are ongoing to assess whether this resilience persists.

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  • Received : 16 Sep 2019
  • Accepted : 25 Oct 2019
  • Published online : 12 Dec 2019
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