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Artemisinin resistance and malaria elimination: Where are we now?
The emergence of artemisinin resistance is a major obstacle to the global malaria eradication/elimination programs. Artemisinin is a very fast-acting antimalarial drug and is the most important drug in the treatment of severe and uncomplicated malaria. For the treatment of acute uncomplicated falcip...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Frontiers Media S.A.
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9538393/ https://www.ncbi.nlm.nih.gov/pubmed/36210819 http://dx.doi.org/10.3389/fphar.2022.876282 |
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author | Hanboonkunupakarn, Borimas Tarning, Joel Pukrittayakamee, Sasithon Chotivanich, Kesinee |
author_facet | Hanboonkunupakarn, Borimas Tarning, Joel Pukrittayakamee, Sasithon Chotivanich, Kesinee |
author_sort | Hanboonkunupakarn, Borimas |
collection | PubMed |
description | The emergence of artemisinin resistance is a major obstacle to the global malaria eradication/elimination programs. Artemisinin is a very fast-acting antimalarial drug and is the most important drug in the treatment of severe and uncomplicated malaria. For the treatment of acute uncomplicated falciparum malaria, artemisinin derivatives are combined with long half-life partner drugs and widely used as artemisinin-based combination therapies (ACTs). Some ACTs have shown decreased efficacy in the Southeast Asian region. Fortunately, artemisinin has an excellent safety profile and resistant infections can still be treated successfully by modifying the ACT. This review describes the pharmacological properties of ACTs, mechanisms of artemisinin resistance and the potential changes needed in the treatment regimens to overcome resistance. The suggested ACT modifications are extension of the duration of the ACT course, alternating use of different ACT regimens, and addition of another antimalarial drug to the standard ACTs (Triple-ACT). Furthermore, a malaria vaccine (e.g., RTS,S vaccine) could be added to mass drug administration (MDA) campaigns to enhance the treatment efficacy and to prevent further artemisinin resistance development. This review concludes that artemisinin remains the most important antimalarial drug, despite the development of drug-resistant falciparum malaria. |
format | Online Article Text |
id | pubmed-9538393 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-95383932022-10-08 Artemisinin resistance and malaria elimination: Where are we now? Hanboonkunupakarn, Borimas Tarning, Joel Pukrittayakamee, Sasithon Chotivanich, Kesinee Front Pharmacol Pharmacology The emergence of artemisinin resistance is a major obstacle to the global malaria eradication/elimination programs. Artemisinin is a very fast-acting antimalarial drug and is the most important drug in the treatment of severe and uncomplicated malaria. For the treatment of acute uncomplicated falciparum malaria, artemisinin derivatives are combined with long half-life partner drugs and widely used as artemisinin-based combination therapies (ACTs). Some ACTs have shown decreased efficacy in the Southeast Asian region. Fortunately, artemisinin has an excellent safety profile and resistant infections can still be treated successfully by modifying the ACT. This review describes the pharmacological properties of ACTs, mechanisms of artemisinin resistance and the potential changes needed in the treatment regimens to overcome resistance. The suggested ACT modifications are extension of the duration of the ACT course, alternating use of different ACT regimens, and addition of another antimalarial drug to the standard ACTs (Triple-ACT). Furthermore, a malaria vaccine (e.g., RTS,S vaccine) could be added to mass drug administration (MDA) campaigns to enhance the treatment efficacy and to prevent further artemisinin resistance development. This review concludes that artemisinin remains the most important antimalarial drug, despite the development of drug-resistant falciparum malaria. Frontiers Media S.A. 2022-09-23 /pmc/articles/PMC9538393/ /pubmed/36210819 http://dx.doi.org/10.3389/fphar.2022.876282 Text en Copyright © 2022 Hanboonkunupakarn, Tarning, Pukrittayakamee and Chotivanich. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Pharmacology Hanboonkunupakarn, Borimas Tarning, Joel Pukrittayakamee, Sasithon Chotivanich, Kesinee Artemisinin resistance and malaria elimination: Where are we now? |
title | Artemisinin resistance and malaria elimination: Where are we now? |
title_full | Artemisinin resistance and malaria elimination: Where are we now? |
title_fullStr | Artemisinin resistance and malaria elimination: Where are we now? |
title_full_unstemmed | Artemisinin resistance and malaria elimination: Where are we now? |
title_short | Artemisinin resistance and malaria elimination: Where are we now? |
title_sort | artemisinin resistance and malaria elimination: where are we now? |
topic | Pharmacology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9538393/ https://www.ncbi.nlm.nih.gov/pubmed/36210819 http://dx.doi.org/10.3389/fphar.2022.876282 |
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