TY - JOUR AU - Wongsrichanalai, Chansuda AU - Meshnick, Steven R T1 - Declining Artesunate-Mefloquine Efficacy against Falciparum Malaria on the Cambodia–Thailand Border T2 - Emerging Infectious Disease journal PY - 2008 VL - 14 IS - 5 SP - 716 SN - 1080-6059 AB - Resistance to many antimalaria drugs developed on the Cambodia–Thailand border long before developing elsewhere. Because antimalaria resistance is now a global problem, artemisinin-based combination therapies (ACTs) are the first-line therapies in most malaria-endemic countries. However, recent clinical and molecular studies suggest the emergence of ACT-resistant Plasmodium falciparum infections in the Cambodia–Thailand border area, where standard ACT is artesunate and mefloquine. These ACT failures might be caused by high-level mefloquine resistance because mefloquine was used for monotherapy long before the introduction of ACT. This observation raises 2 questions. First, how can existing P. falciparum–resistant strains be controlled? Second, how can the evolution of new ACT- resistant strains be avoided elsewhere, e.g., in Africa? Enforcement of rational drug use and improved diagnostic capacity are among the measures needed to avoid and contain ACT resistance. KW - malaria KW - artesunate-mefloquine KW - drug resistance KW - Cambodia KW - Thailand KW - pfmdr1 KW - Plasmodium falciparum KW - ACT KW - anti-malarial KW - rational therapy KW - synopsis DO - 10.3201/eid1405.071601 UR - https://wwwnc.cdc.gov/eid/article/14/5/07-1601_article ER - End of Reference