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Global report on antimalarial efficacy and drug resistance: by World Health Organization

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By World Health Organization

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The red line indicates the threshold of 10% of treatment failure at which countries should initiate a change of the antimalarial medicine recommended in their national malaria treatment policy. In areas where artesunate resistance is low or absent, the therapeutic efficacy of artesunate– amodiaquine is highly correlated with the efficacy of amodiaquine alone. 73). As the treatment failure rate of amodiaquine reaches 22%, the failure rate of the 30 Global report on antimalarial drug efficacy and drug resistance: 2000–2010 artesunate–amodiaquine combination is likely to exceed 10%, the threshold above which WHO recommends to initiate a change in treatment policy (see red lines in Figure 3).

9% treatment failure (Figure 20). 1–12% were reported in Burkina Faso, Cambodia, Kenya, Mozambique, Papua New Guinea and Uganda. Several combinations of dihydroartemisinin and piperaquine have been produced and marketed: dihydroartemisinin–piperaquine–trimethoprim–primaquine, dihydroartemisinin–piperaquine–trimethoprim and dihydroartemisinin–piperaquine. , 2004). 47 3. Global review of antimalarial drug efficacy and drug resistance As observed with artemether–lumefantrine, the major determinant of the parasitological failure of dihydroartemisinin–piperaquine is the plasma concentration of piperaquine on day 7.

41 3. Global review of antimalarial drug efficacy and drug resistance Figure 12. Treatment failure rates with artesunate–amodiaquine in selected in selected countries in Africa (2002–2009) Treatment failure (%) 40 maximum median minimum 30 20 10 0 Madagascar Senegal Nigeria Togo Angola Cameroon Mali Eritrea Ghana Uganda Rwanda Burkina Faso Democratic Kenya Republic of the Congo The box plots depict the following summary statistics for the efficacy studies conducted for each country and drug with a follow-up of 28 days: the minimum value (bottom whisker), the 25th percentile, the median value, the 75th percentile and the maximum value (upper whisker).

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