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History and importance of antimalarial drug resistance

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dc.contributor.author D'Alessandro, U. en_US
dc.contributor.author Buttiëns, H. en_US
dc.date.accessioned 2007-12-06T14:33:20Z
dc.date.available 2007-12-06T14:33:20Z
dc.date.issued 2001 en_US
dc.identifier.issn 1360-2276 en_US
dc.identifier.doi http://dx.doi.org/10.1046/j.1365-3156.2001.00819.x
dc.identifier.other ITG-P1A en_US
dc.identifier.other ITG-HLA en_US
dc.identifier.other HEALTH en_US
dc.identifier.other U-EPID en_US
dc.identifier.other PARAS en_US
dc.identifier.other U-MALAR en_US
dc.identifier.other JIF en_US
dc.identifier.other DOI en_US
dc.identifier.other MULTI en_US
dc.identifier.other ABSTRACT en_US
dc.identifier.other FTB en_US
dc.identifier.uri http://hdl.handle.net/10390/110
dc.description The definitive version is available at www3.interscience.wiley.com
dc.description.abstract The emergence of Plasmodium falciparum resistance to widely used antimalarial drugs such as chloroquine (CQ) has made malaria control and treatment much more difficult. This is particularly dramatic for Africa, as few affordable alternatives are available. Drug pressure has been identified as one of the key factors for the emergence and spread of resistance. The contribution of the extensive use and misuse of antimalarial drugs to the selection of resistant parasites became particularly evident during the Global Malaria Eradication campaign, launched by World Health Organization (WHO) in 1955. The first reports confirming P. falciparum resistance to CQ came almost simultaneously in the early 1960s from South America and South-East Asia, where direct or indirect (through use of medicated cooking salt) mass drug administration (MDA) had been implemented. Similar approaches were very limited in Africa, where P. falciparum resistance to CQ was first reported from the eastern region in the late 1970s and spread progressively west. Most African countries still rely heavily on CQ as first-line treatment despite various levels of resistance, although some states have changed to sulphadoxine-pyrimethamine (SP) as the first-line drug. Unfortunately, the predicted SP useful therapeutic life might be very short, probably because of its prolonged half-life, causing a higher probability of selecting resistant strains and a consequent fast development of resistance. CQ resistance is not evenly distributed and important differences can be found within and between countries. It seems to have spread more rapidly in East than in West Africa. Considering the high level of CQ use in West Africa, other factors such as intensity of transmission, population immunity or population movements should be considered when explaining the different levels of resistance. Understanding such factors may help us in devising strategies to contain the spread of drug resistance. en_US
dc.language English en_US
dc.publisher Blackwell Publishing
dc.subject Protozoal diseases en_US
dc.subject Malaria en_US
dc.subject Drug therapy en_US
dc.subject Chloroquine en_US
dc.subject Sulfadoxine-pyrimethamine en_US
dc.subject Drug resistance en_US
dc.subject Prevention strategies en_US
dc.subject Transmission intensity en_US
dc.subject Immunity en_US
dc.subject Migration en_US
dc.title History and importance of antimalarial drug resistance en_US
dc.type Article en_US
dc.citation.issue 11
dc.citation.jtitle Tropical Medicine and International Health en_US
dc.citation.volume 6 en_US
dc.citation.pages 845-848 en_US
dc.publisher.place Oxford
dc.identifier.pmid http://www.ncbi.nlm.nih.gov/pubmed/11703837
dc.citation.jabbreviation Trop Med Int Health en_US


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