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The Lancet Infect Dis. Mitigating the threat of artemisinin resistance in Africa: improvement of drug-resistance surveillance and response systems
[Source: The Lancet Infectious Diseases, full text: (LINK). Abstract, edited.]
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The Lancet Infectious Diseases, Volume 12, Issue 11, Pages 888 - 896, November 2012
doi:10.1016/S1473-3099(12)70241-4
Mitigating the threat of artemisinin resistance in Africa: improvement of drug-resistance surveillance and response systems
Original Text
Dr Ambrose O Talisuna PhD a b c, Corine Karema d, Bernhards Ogutu PhD e, Elizabeth Juma MD f, John Logedi MD g, Andrew Nyandigisi BPharm g, Modest Mulenga PhD h, Wilfred F Mbacham ScD i, Cally Roper PhD j, Philippe J Guerin PhD b c, Prof Umberto D'Alessandro PhD k l, Prof Robert W Snow FMedSci a b
Summary
Artemisinin-resistant Plasmodium falciparum malaria has emerged in western Cambodia and has been detected in western Thailand. The situation is ominously reminiscent of the emergence of resistance to chloroquine and to sulfadoxine?pyrimethamine several decades ago. Artemisinin resistance is a major threat to global public health, with the most severe potential effects in sub-Saharan Africa, where the disease burden is highest and systems for monitoring and containment of resistance are inadequate. The mechanisms that underlie artemisinin resistance are not fully understood. The main phenotypic trait associated with resistance is a substantial delay in parasite clearance, so far reported in southeast Asia but not in Africa. One of the pillars of the WHO global plan for artemisinin resistance containment is to increase monitoring and surveillance. In this Personal View, we propose strategies that should be adopted by malaria-endemic countries in Africa: resource mobilisation to reactivate regional surveillance networks, establishment of baseline parasite clearance profiles to serve as benchmarks to track emerging artemisinin resistance, improved data sharing to allow pooled analyses to identify rare events, modelling of risk factors for drug resistance, and development and validation of new approaches to monitor resistance.
doi:10.1016/S1473-3099(12)70241-4
Mitigating the threat of artemisinin resistance in Africa: improvement of drug-resistance surveillance and response systems
Original Text
Dr Ambrose O Talisuna PhD a b c, Corine Karema d, Bernhards Ogutu PhD e, Elizabeth Juma MD f, John Logedi MD g, Andrew Nyandigisi BPharm g, Modest Mulenga PhD h, Wilfred F Mbacham ScD i, Cally Roper PhD j, Philippe J Guerin PhD b c, Prof Umberto D'Alessandro PhD k l, Prof Robert W Snow FMedSci a b
Summary
Artemisinin-resistant Plasmodium falciparum malaria has emerged in western Cambodia and has been detected in western Thailand. The situation is ominously reminiscent of the emergence of resistance to chloroquine and to sulfadoxine?pyrimethamine several decades ago. Artemisinin resistance is a major threat to global public health, with the most severe potential effects in sub-Saharan Africa, where the disease burden is highest and systems for monitoring and containment of resistance are inadequate. The mechanisms that underlie artemisinin resistance are not fully understood. The main phenotypic trait associated with resistance is a substantial delay in parasite clearance, so far reported in southeast Asia but not in Africa. One of the pillars of the WHO global plan for artemisinin resistance containment is to increase monitoring and surveillance. In this Personal View, we propose strategies that should be adopted by malaria-endemic countries in Africa: resource mobilisation to reactivate regional surveillance networks, establishment of baseline parasite clearance profiles to serve as benchmarks to track emerging artemisinin resistance, improved data sharing to allow pooled analyses to identify rare events, modelling of risk factors for drug resistance, and development and validation of new approaches to monitor resistance.
a Malaria Public Health and Epidemiology Group, University of Oxford and KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya; b Centre for Tropical Medicine, University of Oxford, Oxford, UK; c Worldwide Antimalarial Resistance Network, Oxford, UK; d Malaria and Other Parasitic Diseases Division, Rwanda Biomedical Center, Ministry of Health, Kigali, Rwanda; e Walter Reed Project, Kenya Medical Research Institute, Kisumu, Kenya; f Kenya Medical Research Institute, Nairobi, Kenya; g Division of Malaria Control, Ministry of Health, Nairobi, Kenya; h Tropical Disease Research Centre, Ndola, Zambia; i Biotechnology Centre, University of Yaound? I, Yaound?, Cameroon; j Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK; k Medical Research Council Unit, Fajara, The Gambia; l Institute of Tropical Medicine, Antwerp, Belgium
Correspondence to: Dr Ambrose O Talisuna, Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, Oxford OX3 7LJ, UK
-Correspondence to: Dr Ambrose O Talisuna, Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, Oxford OX3 7LJ, UK
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