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The spread of antimalarial drug resistance: A mathematical model with practical implications for ACT drug policies

Wirichada Pongtavornpinyo¹, Shunmay Yeung¹, Ian Hastings², Arjen Dondorp¹, Nicholas Day¹ & Nicholas White³

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1. Mahidol - Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine
2. Liverpool School of Topical Medicine
3. Mahidol University, Wellcome Unit, Faculty of Tropical Medicine

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Document Type:

Manuscript

Date:

Received 24 January 2008 05:15 UTC; Posted 24 January 2008

Subjects:

Microbiology, Pharmacology, Bioinformatics

Tags:

• Mathematical model
• artemisinin combination therapy
• antimalarial drugs
• malaria
• epidemiology

Abstract:

Most malaria-endemic countries are implementing a change in antimalarial drug policy to artemisinin combination therapy (ACT). The impact of different drug choices and implementation strategies is uncertain. A comprehensive model was constructed incorporating important epidemiological and biological factors and used to illustrate the spread of resistance in low and high transmission settings. The model predicts robustly that in low transmission settings drug resistance spreads faster than in high transmission settings, and that in low transmission areas ACTs slows the spread of drug resistance to a partner drug, especially at high coverage rates. This effect decreases exponentially with increasing delay in deploying the ACT and decreasing rates of coverage. A major obstacle to achieving the benefits of high coverage is the current cost of the drugs. This argues strongly for a global subsidy to make ACTs generally available and affordable in endemic areas.

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Jean-Pierre Van geertruyden on 01 August 2008 15:40 UTC

Interesting document but Tables and Supplementary information is lacking to interpret adequately.

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This document is licensed to the public under the Creative Commons Attribution 3.0 License

How to cite this document:

Pongtavornpinyo, Wirichada, Yeung, Shunmay, Hastings, Ian, Dondorp, Arjen, Day, Nicholas, and White, Nicholas. The spread of antimalarial drug resistance: A mathematical model with practical implications for ACT drug policies. Available from Nature Precedings <http://hdl.handle.net/10101/npre.2008.1539.1> (2008)

Version info:

Published version:

10.1186/1475-2875-7-229 (Peer Reviewed) Published in Malaria Journal 7:229.

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