RESUMEN
Having faced increased clinical treatment failures with dihydroartemisinin-piperaquine(DHA-PPQ),Cambodia swapped the first line artemisinin-based combination therapy(ACT)from DHA-PPQ to artesunate-mefloquine given that parasites resistant to piperaquine are susceptible to mefloquine.However,triple mutants have now emerged,suggesting that drug rotations may not be adequate to keep resistance at bay.There is,therefore,an urgent need for alternative treatment strategies to tackle resistance and prevent its spread.A proper understanding of all contributors to artemisinin resistance may help us identify novel strategies to keep artemisinins effective until new drugs become available for their replacement.This review highlights the role of the key players in artemisinin resistance,the current strategies to deal with it and suggests ways of protecting future antimalarial drugs from bowing to resistance as their predecessors did.
RESUMEN
Malaria is endemic, to a greater or lesser extent, in the Western Pacific region apart from New Zealand and some islands in the South Pacific. It has practically disappeared from Australia except in its northern part; in Japan, the incidence of the disease has been reduced to such a level that it no longer constitutes a serious public health problem. The greater part of the region, however, is still burdened by this disease.In discussing the possibility of eradicating malaria in the Western Pacific region, one naturally has to consider certain elements which play an essential part in the overall scheme; these are briefly discussed below. (Author)