Assessing Antimalarial Efficacy in a Time of Change to Artemisinin-Based Combination Therapies: The Role of Médecins Sans Frontières

摘要

During the 1990s, high levels of Plasmodium falciparum (Pf) resistance to common antimalarials were reported from malaria-endemic countries, raising questions about the efficacy of chloroquine (CQ), then the mainstay of antimalarial treatment. Drug resistance was considered a prime contributing factor to increased malaria mortality and morbidity across Africa [1,2]. The natural successor to CQ, sulfadoxine-pyrimethamine (SP), had a short therapeutic lifespan [3], and the choice of an effective first-line regimen emerged as a key issue in Pf malaria control. Artemisinin-based combination therapy (ACT), adopted in southeast Asia since the early 1990s, appeared to be the best available option [3].