BMJ  2005;331:706-707 (1 October), doi:10.1136/bmj.331.7519.706

Editorial

Antimalarial treatment with artemisinin combination therapy in Africa

Desirable, achievable, but not easy

The first 150 words of the full text of this article appear below.

The steady increase of drug resistant malaria across Africa is a crisis for which there are achievable solutions, but no easy ones. The scale of the problem is not in doubt. In Africa malaria remains one of the commonest causes of death and serious morbidity, especially for children and pregnant women.¹ Despite a decision in principle by many countries in Africa to use artemisinin based combination therapies (ACTs), most cases of malaria are still treated with monotherapy and in many areas most of these treatments will fail.^{2 3}

Drug combinations, rather than monotherapy, are now seen to be the best solution for treating malaria, and artemisinin based drug combinations are highly effective, with cure rates similar to that of chloroquine 30 years ago. They seem to be a good long term choice for most African countries, being safe and well tolerated (with the caveat that their safety in early pregnancy . . . [Full text of this article]

Malaria Alert Centre, Bantyre, Malawi

Centre for Innovation Against Malaria, Banjul, The Gambia

Makerere University-UCSF Malaria Research Collaboration, PO Box 7475, Kampala, Uganda

Malaria Consortium, Accra, Ghana

Muheza Designated District Hospital, Muheza, Tanga Region, Tanzania

Dangme West District Health Directorate/Research Centre, PO Box 1, Dodowa, Ghana

Division of Clinical Pharmacology, University of Cape Town, South Africa

Gates Malaria Partnership, Department of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London WC1B 3DP (c.whitty@lshtm.ac.uk)

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• del Pilar Crespo, M., Avery, T. D., Hanssen, E., Fox, E., Robinson, T. V., Valente, P., Taylor, D. K., Tilley, L. (2008). Artemisinin and a Series of Novel Endoperoxide Antimalarials Exert Early Effects on Digestive Vacuole Morphology. Antimicrob. Agents Chemother. 52: 98-109 [Abstract] [Full text]  
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