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Researchers show that genetic surveillance can detect drug resistance years before the first warning signs appear in clinics—and help to answer crucial questions about how resistance emerges and spreads.

Image courtesy of Chanaki Amaratunga

Drug resistance once again threatens progress against malaria. Beginning in 2008, clinical studies in Cambodia reported that the frontline antimalarial drug, artemisinin, was taking longer to clear the parasites from the blood of malaria-infected patients—a worrying sign that drug resistance was emerging, again (1-3).

At the time, artemisinin was used in combination with a partner drug, piperaquine, which helped to keep the treatment effective. The combination of dihydroartemisinin and piperaquine (DHA-PPQ) seemed to contain the threat, but then in 2013, researchers began reporting a new outbreak of multidrug resistance—this time to DHA-PPQ (4). The simultaneous failure of both drugs renders the combination therapy powerless to treat these multidrug resistant infections. The situation is fragile, and doctors are left to rely on a small number of drugs.

Find out more (MalariaGEN website)

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