New findings from the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health (NIH), confirm dihydroartemisinin-piperaquine, the first-line treatment for Plasmodium falciparum malaria infection in Cambodia, has failed in certain provinces due to parasite resistance to artemisinin and piperaquine. Dihydroartemisinin-piperaquine is an artemisinin combination therapy (ACT) for malaria that combines potent, fast-acting artemisinin with a long-acting partner drug, piperaquine. Resistance to artemisinin in parts of Southeast Asia is well-documented, but until now only a few studies have presented clear evidence of piperaquine resistance. Additional study findings suggest that artesunate, a form of artemisinin, plus mefloquine, a different long-acting partner drug, should be the first-line ACT in areas where dihydroartemisinin-piperaquine treatment has failed, the study authors note.
Amaratunga C, Lim P, et al. Dihydroartemisinin-piperaquine resistance in Plasmodium falciparum malaria in Cambodia: a multi-site observational cohort study. The Lancet Infectious Diseases DOI: 10.1016/S1473-3099(15)00487-9 (2016).
Rick M. Fairhurst, M.D., Ph.D., chief, Malaria Pathogenesis and Human Immunity Unit in NIAID's Laboratory of Malaria and Vector Research, is available to comment on this research.