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 Previous Article

Clinical Microbiology Reviews, January 2004, p. 235-254, Vol. 17, No. 1
0893-8512/04/$08.00+0     DOI: 10.1128/CMR.17.1.235-254.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.

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

Ambrose O. Talisuna,1,2 Peter Bloland,3 and Umberto D’Alessandro2*

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.

* Corresponding author. Mailing address: Prince Leopold Institute of Tropical Medicine, Nationalestraat 155, B-2000 Antwerp, Belgium. Phone: 0032 3 247 6354. Fax: 0032 3 247 6362. E-mail: udalessandro{at}itg.be.

Clinical Microbiology Reviews, January 2004, p. 235-254, Vol. 17, No. 1
0893-8512/04/$08.00+0     DOI: 10.1128/CMR.17.1.235-254.2004
Copyright © 2004, American Society for Microbiology. All Rights Reserved.



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