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Multidrug-resistant malaria and the impact of mass drug administration

Authors Zuber JA, Takala-Harrison S

Received 17 October 2017

Accepted for publication 18 December 2017

Published 1 March 2018 Volume 2018:11 Pages 299—306


Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Lucy Goodman

Peer reviewer comments 3

Editor who approved publication: Dr Joachim Wink

Janie Anne Zuber, Shannon Takala-Harrison

Division of Malaria Research, Institute for Global Health, University of Maryland School of Medicine, Baltimore, MD, USA

Based on the emergence and spread throughout the Greater Mekong Subregion (GMS) of multiple artemisinin-resistant lineages, the prevalence of multidrug resistance leading to high rates of artemisinin-based combination treatment failure in parts of the GMS, and the declining malaria burden in the region, the World Health Organization has recommended complete elimination of falciparum malaria from the GMS. Mass drug administration (MDA) is being piloted as one elimination intervention to be employed as part of this effort. However, concerns remain as to whether MDA might exacerbate the already prevalent problem of multidrug resistance in the region. In this review, we briefly discuss challenges of MDA, the use of MDA in the context of multidrug-resistant malaria, and the potential of different drug combinations and drug-based elimination strategies for mitigating the emergence and spread of resistance.

Keywords: malaria, drug resistance, mass drug administration

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