Is mass drug administration fighting fire with a fire? Mass drug administration (MDA) was a component of many malaria programs during the eradication era, but later was seldomly deployed due to concerns regarding efficacy and feasibility and fear of accelerating drug resistance. The failure of chloroquine MDA is well known. R D Powell, and C W D Tigertt. Drug Resistance of Parasites Causing Human Malaria. Annual Review of Medicine. Vol. 19: 81-102 (Volume publication date February 1968) DOI: 10.1146/annurev.me.19.020168.000501 In The...

Some recent research, mostly in relation with the resistance to ACT pills and/or artesunate injections, has highlighted serious secundary health effects at the doses prescribed by WHO. The scientific literature describes a wide array : haemolytic, hepatotoxic, cytotoxic, neurotoxic, cardiotoxic, genotoxic, ototoxic, embryotoxic, spleenotoxic, hemolytic, atherosclerosis, spermatoxicity, immunodepressive effects of chemical artemisinine derivatives and artemisinin combined therapies (ACTs) Fears of emerging artemisin resistance in...

Oral monotherapy has been banned by WHO, but parenteral monotherapy therapy in accordance with the 2010 World Health Organization Guidelines is again recommended in case of severe malaria. Artemisinin derivatives not only lead to resistance, widespread in Africa now. N Van Hong and U. d’Alessandro describe the case of a man with severe malaria who does not respond to intravenous artesunate. Van Hong N, Amambua-Ngwa A, Tuan NQ, Cuong DD, Giang NTH, Van Dung N, U d’Alessandro. Severe malaria not responsive to artemisinin derivatives...

Over the last century all monotherapies (quinine, chloroquine, mefloquine, lumefantrine, piperaquine, pyrimethamine, halofantrine) have lead to rapid resistances of Plasmodium falciparum. Combination therapy betweeen artemisinin and molecules with long lasting action had raised optimism. But already in 2003 first signs of resistance developed in South-East Asia. It has been established meanwhile that they were mostly related to mutations in the kelch13 propeller region of the parasite. Mutations have meanwhile raised to 90%. Timothy J.C....

A recent paper from Mali is alarming. Abdoulaye A. Djimde, Amelia W. Maiga, Dinkorma, Ouologuem, Bakary Fofana, Issaka Sagara, Demba Dembele, Sekou Toure, Kassim Sanogo, Souleymane Dama, Bakary Sidibe, and Ogobara K. Doumbo. Gametocyte clearance dynamics following oral artesunate treatment of uncomplicated falciparum malaria in Malian children. Parasite. 2016; 23: 3. doi: 10.1051/parasite/2016003. The same recrudescence with oral artemisinin monotherapy had already been observed in Vietnam in 2001. P T Giao, T Q Binh, P A Kager, H...