Title
Intensity of malaria transmission and the spread of **Plasmodium falciparum**resistant malaria: a review of epidemiologic field evidence Intensity of malaria transmission and the spread of **Plasmodium falciparum**resistant malaria: a review of epidemiologic field evidence
Author
Faculty/Department
Faculty of Pharmaceutical, Biomedical and Veterinary Sciences. Pharmacy
Publication type
article
Publication
Baltimore, Md ,
Subject
Human medicine
Source (journal)
The American journal of tropical medicine and hygiene. - Baltimore, Md
Volume/pages
77(2007) :6:S , p. 170-180
ISSN
0002-9637
ISI
000252212600027
Carrier
E
Target language
English (eng)
Affiliation
University of Antwerp
Abstract
Malaria transmission intensity has been proposed, based on theoretical models, as an important factor for the spread of falciparum-resistant malaria, but the predictions obtained vary according to the assumptions inherent in the model used. We summarized the available field data on transmission intensity and the prevalence of malaria drug resistance. Resistance to chloroquine and sulphadoxine-pyrimethamine monotherapy was invariably higher where transmission was intense. Vector control interventions were associated with a better chloroquine and sulfadoxine-pyrimethamine efficacy. However, high resistance to chloroquine and also to combination therapy (chloroquine plus sulphadoxine-pyrimethamine and amodiaquine plus sulfadoxine-pyrimethamine) was also observed in very low transmission areas. Reducing transmission intensity is likely to slow the spread of drug resistance. Nevertheless, where transmission is extremely low, to limit the unnecessary use of antimalarials and a consequent paradoxical acceleration of the spread of resistance, patients should be treated only after laboratory confirmation of malaria.
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