Cookies on this website
We use cookies to ensure that we give you the best experience on our website. If you click 'Continue' we'll assume that you are happy to receive all cookies and you won't see this message again. Click 'Find out more' for information on how to change your cookie settings.

Antimalarial drug resistance emerges de novo predominantly in areas of low malaria transmission. Because of the logarithmic distribution of parasite numbers in human malaria infections, inadequately treated high biomass infections are a major source of de novo antimalarial resistance, whereas use of antimalarial prophylaxis provides a low resistance selection risk. Slowly eliminated antimalarials encourage resistance largely by providing a selective filter for resistant parasites acquired from others, and not by selecting resistance de novo. The de novo emergence of resistance can be prevented by use of antimalarial combinations. Artemisinin derivative combinations are particularly effective. Ensuring adequate treatment of the relatively few heavily infected patients would slow the emergence of resistance.

Original publication

DOI

10.1098/rspb.2002.2241

Type

Journal article

Journal

Proc Biol Sci

Publication Date

07/03/2003

Volume

270

Pages

545 - 554

Keywords

Animals, Antimalarials, Biological Evolution, Dose-Response Relationship, Drug, Drug Resistance, Malaria, Plasmodium falciparum, Selection, Genetic