title: Antimalarial drug resistance in Africa: key lessons for the future.
abstract: Drug-resistant parasites repeatedly arise as a result of widespread use of antimalarial drugs and have contributed significantly to the failure to control and eradicate malaria throughout the world. In this review, we describe the spread of resistance to chloroquine and sulfadoxine-pyrimethamine, two old drugs that are no longer used owing to high rates of resistance, and examine the effect of the removal of drug pressure on the survival of resistant parasites. Artemisinin-resistant malaria is now emerging in Southeast Asia in a unique and unexpected pattern. We will review the most recent genomic and clinical data to help predict the behavior of resistance to new antimalarial medications and inform strategies to prevent the spread of drug-resistant malaria in Africa in the future.
authors.affiliation: Center for Vaccine Development, University of Maryland School of Medicine, Baltimore, Maryland.
authors.forename: Shannon
authors.initials: S
authors.lastname: Takala-Harrison
authors.forename: Miriam K
authors.initials: MK
authors.lastname: Laufer
mesh_terms: D000349:Africa / Q000453:epidemiology; D000818:Animals; D000962:Antimalarials / Q000008:administration & dosage*; D037621:Artemisinins / Q000008:administration & dosage; D002738:Chloroquine / Q000008:administration & dosage; D004338:Drug Combinations; D004351:Drug Resistance / Q000187:drug effects / Q000502:physiology*; D004359:Drug Therapy, Combination; D005544:Forecasting; D006801:Humans; D008288:Malaria / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*; D011739:Pyrimethamine / Q000008:administration & dosage; D013413:Sulfadoxine / Q000008:administration & dosage
chemical_list: D000962:Antimalarials; D037621:Artemisinins; D004338:Drug Combinations; C001205:fanasil, pyrimethamine drug combination; D013413:Sulfadoxine; D002738:Chloroquine; C031327:artemisinin; D011739:Pyrimethamine
keywords: Africa; artemisinin resistance; artemisinin-based combination therapy; drug resistance; malaria; molecular epidemiology