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Preventing anti-malarial drug resistance in India

Date: 04 October 2021 Tags: Miscellaneous


A new study has found evidence of the failure of artemisinin-based combination therapy for treating falciparum malaria.



Malaria-endemic countries such India rely on Artemisinin-based antimalarial drugs for treating against Plasmodium falciparum parasite.



  • Plasmodium falciparum parasite is responsible for majority of death caused due to Malaria disease.

  • The study was published in an article named `Evidence of Artemisinin-Resistant Malaria in Africa’. It talks about certain mutations that are responsible for artemisinin resistance in Northern Uganda. 

  • The resistance offered to artemisinin drug in East Africa is a great concern as majority of lives in the region was saved using it.


Treatment in India

  • Initially, chloroquine was used to treat malarial infections. After understanding about its failure to stop P. falciparum malaria successfully, it was discarded.

  • In 117 districts of the country reporting 90% of P. falciparum infection burden were identified and artemisinin-based combination therapy was introduced in 2008.

  • Artesunate plus sulfadoxine-pyrimethamine (AS+SP) therapy introduced in 2010 was reported to be unsuccessful due to the resistance offered to SP.

  • In North-eastern states where resistance was observed, the combination partner was replaced by artemether-lumefantrine (AL).

  • There have been reports of chloroquine resistance in P. vivax malaria. Still it is used effectively to treat infections of the malaria species.


Artemisinin failure

The use of artemisinin-based combination therapy showed failure in central Indian states. The partner drug SP indicated triple mutations with artemisinin wild type.


Resistance history

  • The chloroquine resistance was not ingeniously developed. It first emerged in South-East Asia and later migrated to India and then to other continents.

  • The artemisinin resistance also developed in six Southeast Asian countries and migrated to other continents. It may be following the same path as chloroquine resistance.


Way forward

It is necessary to carry out Molecular Malaria Surveillance to find out the drug-resistant variants so that corrective steps can be adopted in time to avoid any consequences. 

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