loading page

Advances and roadblocks in the Treatment of Malaria
  • Nicholas White,
  • Borimas Hanboonkunupakarn
Nicholas White
Faculty of Tropical Medicine, Mahidol Iniversity
Author Profile
Borimas Hanboonkunupakarn
Mahidol University
Author Profile

Abstract

The deployment of artesunate for severe malaria and the artemisinin combination therapies (ACTs) for uncomplicated malaria has been a major advance in antimalarial therapeutics. These drugs have reduced treated mortality, accelerated recovery, and reduced treatment failure rates and transmission from the treated infection. These drugs remain highly effective against falciparum malaria in most malaria endemic areas but significant resistance has emerged in the Greater Mekong subregion of Southeast Asia. Resistance to artemisinin was followed by resistance in the ACT partner drugs, and fit multidrug resistant parasite lineages have now spread widely across the region. ACTs are highly effective against P. vivax and the other malaria species. Recent studies show that radical curative regimens of primaquine (to prevent relapse) can be shortened to seven days, and that the newly introduced single dose tafenoquine is an alternative, although the currently recommended dose is insufficient in Southeast Asia and Oceania. Targeted malaria elimination using focal mass treatments with dihydroartemisinin-piperaquine have proved safe and effective malaria elimination accelerators, but progress overall towards malaria elimination is very slow. Indeed since 2015 overall malaria case numbers globally have risen.

Peer review status:ACCEPTED

16 Apr 2020Submitted to British Journal of Clinical Pharmacology
17 Apr 2020Submission Checks Completed
17 Apr 2020Assigned to Editor
20 Apr 2020Reviewer(s) Assigned
03 May 2020Review(s) Completed, Editorial Evaluation Pending
09 May 2020Editorial Decision: Revise Minor
10 May 20201st Revision Received
12 May 2020Submission Checks Completed
12 May 2020Assigned to Editor
12 May 2020Review(s) Completed, Editorial Evaluation Pending
16 May 2020Editorial Decision: Accept