The decreasing effectiveness of antimalarial therapy due to drug resistance necessitates constant efforts to develop new drugs. Artemisinin derivatives are the most recent drugs that have been introduced and are considered the first line of treatment, but there are already indications of Plasmodium falciparum resistance to artemisinins. Consequently, drug combinations are recommended for preven...

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BACKGROUND The World Health Organization (WHO) is promoting artemether-lumefantrine for treating uncomplicated malaria. The objective of this review is to summarize available evidence of its effects compared with other antimalarial regimens. METHODS We sought randomized and quasi-randomized studies comparing artemether-lumefantrine with any other antimalarial drug regimen. Databases searched ...

Objective: This study was conducted to evaluate the modes of clinical presentations of falciparum malaria. Design: Descriptive study. Place and Duration of Study: Medical Unit 5, Civil Hospital Karachi and Ankle Sria Hospital Karachi from August 2003 to December 2005. Methods: A total of 348 patients admitted with fever were screened with peripheral blood smear for malarial parasite. One hundre...

1. Price RN, Uhlemann AC, Brockman A, McReady R, Ashley E, Phaipun L, et al. Mefloquine resistance in Plasmodium falciparum and increased pfmdr1 gene copy number. Lancet. 2004;364: 438–47. http://dx.doi.org/10.1016/S01406736(04)16767-6 2. Basco LK, Le Bras J, Rhoades Z, Wilson CM. Analysis of pfmdr1 and drug susceptibility in fresh isolates of Plasmodium falciparum from Subsaharan Africa. Mol B...

Editorial Adverse drug reaction of the month-a new series This issue of the Postgraduate Medical Journal sees the launch of a new series of articles, Adverse drug reaction of the month. The series has two objectives. First, it is intended to inform practising clinicians about significant adverse reactions (ADRs), as well as their diagnosis, management and prevention. Second, we unashamedly wish...

The in vitro activities of dihydroartemkinin (the biologically active metabolite of artemisinin derivatives), chloroquine, monodesethylamodiaquine (the biologically active metabolite of amodiaquine), quinine, mefloquine, halofantrine, and pyrimethamine were assessed in 65 African isolates of Plasmodium falciparum from Yaounde, Cameroon using an isotopic microtest. The 50% inhibitory concentrati...

Resistance to antifolate antimalarial drugs (cycloguanil, a biologically active metabolite of pioguanil, and pyrimethamine) is associated with a Serto Asn108 point mutation in the dihydrofolate reductase-thymidylate synthase gene of Plasmodium falciparunt. The frequency of this mutation was studied in 127 clinical isolates obtained in Yaounde, Cameroon using a simple and rapid molecular techniq...

Background: Artemisinin-resistant Plasmodium falciparum has emerged in the Greater Mekong sub-region and poses a major global public health threat. Slow parasite clearance is a key clinical manifestation of reduced susceptibility to artemisinin. This study was designed to establish the baseline values for clearance in patients from Sub-Saharan African countries with uncomplicated malaria treate...