Malaria is a major public health problem affecting over 2 billion people in 90 countries. Each year there are 300-500 million cases of malaria resulting in 1.5-2.7 million deaths, mostly young children in Africa. Progress made in reducing malaria has been eroding due to factors like land use changes, climate change, conflict, and the development of drug-resistant strains of the malaria parasite. Most malaria-endemic areas now show resistance to chloroquine and sulfadoxine-pyrimethamine, and resistance to mefloquine has emerged in Southeast Asia where multi-drug resistance occurs.
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Artemisinin
1. Epidemiology of Malaria
drug-resistant malaria is a rapidly spreading global health threat
Malaria is a public health problem today in more than 90 countries, inhabited by 2,400 million people – 40% of the
world’s population
An estimated 300 to 500 million cases each year cause 1.5 to 2.7 million deaths, more than 90% of which occur in
children under age 5 in Africa. Malaria kills one child every 30 seconds
Progresses made in the last 50 years in restricting the geographical areas affected by malaria are being eroded
recently, due to changes in land use, global climate changes, armed conflicts/movement of refugees, easy
international travel and development of multi-drug resistant strains of parasite.
The vast majority of areas of endemic malaria show resistance to chloroquine (the oldest, cheapest treatment).
Resistance to sulfadoxine-pyrimidine is emerging in most affected areas. Resistence to mefloquine has been
observed in South-east Asia (areas of multi-drug resistance)
No malaria
Malaria present only in small, remote areas. No chloroquine-resistant
P.falciparum.
Malaria transmision areas
Intermediate malaria risk, no chloroquine-resistant strains of P.falciparum. Multidrug resistance areas
Intermediate malaria risk, but chloroquine-resistance of P.falciparum is Chloroquine resistance areas
conf irmed. Malaria-f ree islands
Sulf adoxine –py rimethamine resistance areas
High risk area f or chloroquine-resistant Plasmodium falciparum.
No clinically relevant resistance has been observed with artemisinin and related derivatives
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