title: Monitoring antimalarial drug resistance: Applying lessons learned from the past in a fast-moving present.
abstract: The need for robust surveillance of antimalarial drugs is more urgent than it has ever been. In the western region of Cambodia, artemisinin resistance has emerged in Plasmodium falciparum and threatens to undermine the efficacy of highly effective artemisinin combination therapies. Although some manfestations of artemisinin tolerance are unique to this class of drug, many of its properties mirror previous experience in understanding and tracking resistance to other antimalarials. In this review we outline the spectrum of approaches that were developed to understand the evolution and spread of antifolate resistance, highlighting the importance of integrating information from different methodologies towards a better understanding of the underlying biologic processes. We consider how to apply our experience in investigating and attempting to contain antifolate resistance to inform our prospective assessment of novel antimalarial resistance patterns and their subsequent spread.
authors.affiliation: WorldWide Antimalarial Resistance Network, Box 355065, University of Washington, Seattle, WA 98195 5065, USA.
authors.forename: Carol Hopkins
authors.initials: CH
authors.lastname: Sibley
authors.affiliation: Global Health Division, Menzies School of Health Research and Charles Darwin University, Darwin, Northern Territory, Australia ; Center for Tropical Medicine, Nuffield Department of Clinical Medicine, University of Oxford, United Kingdom.
authors.forename: Ric N
authors.initials: RN
authors.lastname: Price
keywords: Artemisinin; Drug resistance; Malaria; Surveillance