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The International Journal of the Royal Society of Thailand
Volume XI - 2019

Figure 3 Innovative pipeline for malaria elimination (modified from WHO, 2015)

Containment of artemisinin-resistant malaria

Artemisinin-based combination therapy (ACT) is a two-drug regimen
consisting of a short-acting artemisinin derivative plus another antimalarial drug
with a longer half-life. There are more than seven co-formulated ACTs certified by
the WHO as first line treatment for uncomplicated falciparum malaria (Table 2).

Table 2. The standard regimens of artemisinin-based combination therapy (ACT).

• Artemether + lumefantrine (Coartem)
• Artesunate + amodiaquine (Coarsucam)
• Artesunate + mefloquine

• Dihydroartemisinin + piperaquine (Artekin/Euratesim/Cotecxin)

• Artesunate + sulfadoxine-pyrimethamine
• Dihydroartemisinin + piperaquine + trimetoprim (Artecom)
• Artesunate + pyronaridine (Pyramax)

(WHO treatment guidelines, 3 Edition, 2015)
rd

The emergence of artemisinin resistant P. falciparum strains in Cambodia
in 2007 and along the Thai-Myanmar borders in 2010 are major threats to the
malaria control in the 21 century. The Faculty of Tropical Medicine conducted
st
with international cooperation two large intercontinental research projects during
2013-2018 in over 10 countries in Asia and Africa. The primary objectives were to
contain and eliminate artemisinin and ACT-resistant P. falciparum parasites. The

first study conducted during 2013-2015 was to define the extent of artemisinin
resistance and the ACT cure rate followed by a second study during 2015-2018 to
evaluate the safety and efficacy of triple artemisinin-based combination therapies

16 Precision Tools for Malaria Control and Mahidol University’s
Research on the Malaria Elimination

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