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History, Dynamics, and Public Health Importance of Malaria Parasite Resistance

Ministry of Health, Epidemiological Surveillance Division, Kampala, Uganda,¹ Prince Leopold Institute of Tropical Medicine and Hygiene, Antwerp, Belgium,² Malaria Epidemiology Branch, Division of Parasitic Disease, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia³

Despite considerable efforts, malaria is still one of the most devastating infectious diseases in the tropics. The rapid spread of antimalarial drug resistance currently compounds this grim picture. In this paper, we review the history of antimalarial drug resistance and the methods for monitoring it and assess the current magnitude and burden of parasite resistance to two commonly used drugs: chloroquine and sulfadoxine-pyrimethamine. Furthermore, we review the factors involved in the emergence and spread of drug resistance and highlight its public health importance. Finally, we discuss ways of dealing with such a problem by using combination therapy and suggest some of the research themes needing urgent answers.

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