title: Fighting fire with fire: mass antimalarial drug administrations in an era of antimalarial resistance.
abstract: The emergence and spread of antimalarial resistance has been a major liability for malaria control. The spread of chloroquine-resistant Plasmodium falciparum strains had catastrophic consequences for people in malaria-endemic regions, particularly in sub-Saharan Africa. The recent emergence of artemisinin-resistant P. falciparum strains is of highest concern. Current efforts to contain artemisinin resistance have yet to show success. In the absence of more promising plans, it has been suggested to eliminate falciparum malaria from foci of artemisinin resistance using a multipronged approach, including mass drug administrations. The use of mass drug administrations is controversial as it increases drug pressure. Based on current knowledge it is difficult to conceptualize how targeted malaria elimination could contribute to artemisinin resistance, provided a full treatment course is ensured.
authors.affiliation: Mahidol-Oxford Tropical Medicine Research Unit (MORU) - Faculty of Tropical Medicine, 420/6 Rajvithi Road Bangkok 10400, Thailand.
authors.forename: Lorenz
authors.initials: L
authors.lastname: von Seidlein
authors.forename: Arjen
authors.initials: A
authors.lastname: Dondorp
mesh_terms: D000962:Antimalarials / Q000266:history / Q000627:therapeutic use*; D037621:Artemisinins / Q000266:history / Q000627:therapeutic use; D002738:Chloroquine / Q000266:history / Q000627:therapeutic use; D004351:Drug Resistance / Q000187:drug effects*; D004359:Drug Therapy, Combination; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D016778:Malaria, Falciparum / Q000188:drug therapy*; D010963:Plasmodium falciparum / Q000187:drug effects*; D011739:Pyrimethamine / Q000266:history / Q000627:therapeutic use; D013413:Sulfadoxine / Q000266:history / Q000627:therapeutic use
chemical_list: D000962:Antimalarials; D037621:Artemisinins; D013413:Sulfadoxine; D002738:Chloroquine; C031327:artemisinin; D011739:Pyrimethamine
keywords: Plasmodium falciparum; artemisinins; chloroquine; drug resistance; elimination; malaria; mass drug administrations; pyrimethamine; sulfadoxine