Artemisinin-resistant malaria in Africa demands urgent action

• 成果类型: Editorial Material
• 署名作者: Dhorda, Mehul; Kaneko, Akira; Komatsu, Ryuichi; Achyut, K. C.; Mshamu, Salum; Gesase, Samwel; Kapologwe, Ntuli; Assefa, Ashenafi; Opigo, Jimmy; Adoke, Yeka; Ebong, Chris; Karema, Corine; Uwimana, Aline; Mangara, Jean-Louis Ndikumana; Amaratunga, Chanaki; Peto, Thomas J.; Tripura, Rupam; Callery, James J.; Adhikari, Bipin; Mukaka, Mavuto; Cheah, Phaik Yeong; Mutesa, Leon; Day, Nicholas P. J.; Barnes, Karen I.; Dondorp, Arjen; Rosenthal, Philip J.; White, Nicholas J.; von Seidlein, Lorenz
• 署名单位: Mahidol Oxford Tropical Medicine Research Unit (MORU); Mahidol University; University of Oxford; Karolinska Institutet; Nagasaki University; National Institute of Medical Research; University of North Carolina; University of North Carolina Chapel Hill; Ministry of Health - Uganda; Rwanda Biomedical Center; University of Rwanda; University of Cape Town; University of California System; University of California San Francisco
• 刊物名称: SCIENCE
• ISSN/ISSBN: 0036-11193
• DOI: 10.1126/science.adp5137
• 发表日期: 2024-07-19
• 页码: 252-254
• 关键词: plasmodium-falciparum; SPREAD

摘要

Artemisinin derivatives are the cornerstone of current antimalarial treatment, both for severe malaria (injectable artesunate) and uncomplicated malaria [artemisinin combination therapy (ACT)]. Although a large but poorly defined proportion of malaria infections remains undiagnosed, about 249 million uncomplicated cases were estimated worldwide in 2022, of which roughly 65% were treated with ACTs. Of these cases, 233 million (94%) occurred in Africa ( 1 ), where >70% of uncomplicated falciparum malaria cases are now treated with the ACT artemether-lumefantrine (AL). Unfortunately, artemisinin resistance (ART-R) has emerged in multiple locations in Africa, compromising the efficacy of ACTs. In the past, the spread of antimalarial resistance resulted in millions of avoidable deaths. Without radical action, this history will repeat itself. Success in containing ART-R in the Greater Mekong Subregion in Asia, where ART-R was first reported in 2008, suggests that a multipronged approach is needed in East Africa to reduce and interrupt malaria transmission permanently.