Anti-malarial stewardship for India: an evidence-based approach
DOI:
https://doi.org/10.18203/2394-6040.ijcmph20254468Keywords:
Plasmodium falciparum , Artemisinin combination therapy , Anti-malarial stewardshipAbstract
Plasmodium falciparum (Pf) is a public health problem in both rural as well as urban areas due to changing environmental condition and extensive movement of people. Artemisinin combination therapy (ACT) is the cornerstone of treatment for Pf malaria. However, parasite susceptibility to either artemisinin or the partner drug is getting changed globally. Malaria endemic countries are doing robust surveillance on anti-malarial resistance throughout the year. The recommended ACT regimen differs from country to country and also in different states of the same country.
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References
National Center for Vector Borne Diseases Control Directorate General of Health Services Ministry of Health and Family Welfare, Government of India. 2023. Available at: https://ncvbdc.mohfw.gov.in/. Accessed on 17 October 2025.
Dondorp AM, Nosten F, Yi P, Das D, Phyo AP, Tarning J, et al. Artemisinin resistance in Plasmodium falciparum malaria. N Engl J Med. 2009;361(5):455-67. DOI: https://doi.org/10.1056/NEJMoa0808859
Ashley EA, Dhorda M, Fairhurst RM, Amaratunga C, Lim P, Suon S, et al. Spread of artemisinin resistance in Plasmodium falciparum malaria. N Engl J Med. 2014;371(5):411-23. DOI: https://doi.org/10.1056/NEJMoa1314981
Mohapatra PK, Sarma DK, Prakash A, Bora K, Ahmed MA, Sarma B, et al. Molecular evidence of increased resistance to anti-folate drugs in Plasmodium falciparum in North-East India: a signal for potential failure of artemisinin plus sulphadoxine-pyrimethamine combination therapy. PLoS One. 2014;9(9):e105562. DOI: https://doi.org/10.1371/journal.pone.0105562
Mishra N, Kaitholia K, Srivastava B, Shah NK, Narayan JP, Dev V, et al. Declining efficacy of artesunate plus sulphadoxine-pyrimethamine in northeastern India. Malar J. 2014;13:284. DOI: https://doi.org/10.1186/1475-2875-13-284
Sisowath C, Strömberg J, Mårtensson A, Msellem M, Obondo C, Björkman A, et al. In vivo selection of Plasmodium falciparum pfmdr1 86N coding alleles by artemether-lumefantrine (Coartem). J Infect Dis. 2005;191(6):1014-7. DOI: https://doi.org/10.1086/427997
Malmberg M, Ngasala B, Ferreira PE, Larsson E, Jovel I, Hjalmarsson A, et al. Temporal trends of molecular markers associated with artemether-lumefantrine tolerance/resistance in Bagamoyo district, Tanzania. Malar J. 2013;12:103. DOI: https://doi.org/10.1186/1475-2875-12-103
Okell LC, Reiter LM, Ebbe LS, Baraka V, Bisanzio D, Watson OJ, et al. Emerging implications of policies on malaria treatment: genetic changes in the Pfmdr-1 gene affecting susceptibility to artemether-lumefantrine and artesunate-amodiaquine in Africa. BMJ Glob Health. 2018;3(5):e000999. DOI: https://doi.org/10.1136/bmjgh-2018-000999
Venkatesan M, Gadalla NB, Stepniewska K, Dahal P, Nsanzabana C, Moriera C, et al. Polymorphisms in Plasmodium falciparum chloroquine resistance transporter and multidrug resistance 1 genes: parasite risk factors that affect treatment outcomes for P. falciparum malaria after artemether-lumefantrine and artesunate-amodiaquine. Am J Trop Med Hyg. 2014;91(4):833-43. DOI: https://doi.org/10.4269/ajtmh.14-0031
Rosenthal PJ, Asua V, Conrad MD. Emergence, transmission dynamics and mechanisms of artemisinin partial resistance in malaria parasites in Africa. Nat Rev Microbiol. 2024;22(6):373-84. DOI: https://doi.org/10.1038/s41579-024-01008-2