Artemisinin Partial Resistance and the Treatment of Severe Malaria

One of the greatest threats to the control of malaria is the emergence of artemisinin partial resistance (ART-R) in Plasmodium falciparum, the most virulent human malaria parasite, in multiple countries in Africa. Artemisinins are rapid-acting antimalarial therapeutic agents that are the key components of artemisinin-based combination therapy, which combines an artemisinin derivative with a longer-acting partner drug to treat uncomplicated falciparum malaria. Artemisinin-based combination therapies are the standard of care for this indication. In addition, the artemisinin derivative artesunate, provided intravenously or intramuscularly, is the standard of care to treat severe falciparum malaria, offering significantly improved survival compared with the prior standard, quinine, in African children. Artemisinin partial resistance is manifest as delayed parasite clearance after treatment and was first identified in Southeast Asia in 2008.