Artesunate-resistant Plasmodium falciparum at a Tertiary Care Hospital in North India

The emergence of artemisinin resistance poses a serious global challenge to malaria elimination programs. Artemisinin and its derivatives, especially artesunate, are highly effective against Plasmodium falciparum, particularly in severe and uncomplicated cases. However, increasing reports of treatment failure, particularly with artesunate monotherapy, raise concerns regarding emerging resistance. We present a clinically significant case of suspected artesunate-resistant P. falciparum in an Indian male residing in Nigeria. Despite standard therapy, parasite clearance was delayed, necessitating therapeutic modification. While this case report demonstrates clinical resistance, the lack of confirmatory genetic testing (such as Pfkelch13 mutation screening) remains a limitation.