Plasmodium falciparum Resistance to Artemisinin Derivatives and Piperaquine: A Major Challenge for Malaria Elimination in Cambodia

Artemisinin-based combination therapies (ACTs) are the cornerstone of current strategies for fighting malaria. Over the last decade, ACTs have played a major role in decreasing malaria burden. However, this progress is being jeopardized by the emergence of artemisinin-resistant Plasmodium falciparum...

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Bibliographic Details
Published in:The American journal of tropical medicine and hygiene 2016-12, Vol.95 (6), p.1228-1238
Main Authors: Duru, Valentine, Witkowski, Benoit, Ménard, Didier
Format: Article
Language:English
Subjects:
Animals
Artemisinins
Artemisinins - therapeutic use
Cambodia
Cambodia - epidemiology
Drug Resistance
Human health and pathology
Humans
Infectious diseases
Life Sciences
Malaria, Falciparum
Malaria, Falciparum - epidemiology
Malaria, Falciparum - parasitology
Plasmodium falciparum
Plasmodium falciparum - drug effects
Quinolines
Quinolines - administration & dosage
Quinolines - therapeutic use
Review
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Summary:Artemisinin-based combination therapies (ACTs) are the cornerstone of current strategies for fighting malaria. Over the last decade, ACTs have played a major role in decreasing malaria burden. However, this progress is being jeopardized by the emergence of artemisinin-resistant Plasmodium falciparum parasites. Artemisinin resistance was first detected in western Cambodia in 2008 and has since been observed in neighboring countries in southeast Asia. The problem of antimalarial drug resistance has recently worsened in Cambodia, with reports of parasites resistant to piperaquine, the latest generation of partner drug used in combination with dihydroartemisinin, leading to worrying rates of clinical treatment failure. The monitoring and the comprehension of both types of resistance are crucial to prevent the spread of multidrug-resistant parasites outside southeast Asia, and particularly to Africa, where the public health consequences would be catastrophic. To this end, new tools are required for studying the biological and molecular mechanisms underlying resistance to antimalarial drugs and for monitoring the geographic distribution of the resistant parasites. In this review, we detail the major advances in our understanding of resistance to artemisinin and piperaquine and define the challenges that the malaria community will have to face in the coming years.
ISSN:0002-9637
1476-1645
DOI:10.4269/ajtmh.16-0234