Antimalarial drug efficacy and resistance: Insights from northern Uganda

Artemisinin in combination is the first-line treatment for Plasmodium falciparum malaria in almost all regions. However, by the late 2000s, partial resistance, characterized by delayed parasite clearance after treatment, emerged in the Greater Mekong Subregion and rapidly expanded its range. Since 2013, we have conducted comprehensive malaria drug resistance surveillance in northern Uganda. In 2014, we identified in vitro artemisinin resistance, and by 2017, clinical partial resistance had also been observed. Additionally, we discovered the re-emergence of chloroquine sensitivity in this region as early as 2013, earlier than in the other parts of Uganda. This review aims to summarize our findings from northern Uganda, contextualizing them within similar studies conducted in other regions.