Abstract
Facing chloroquine drug resistance, Angola promptly adopted artemisinin-based combination therapy as the first-line to treat malaria. Currently, the country aims to consolidate malaria control, while preparing for the elimination of the disease, along with others African countries in the region. However, the remarkable capacity of Plasmodium to develop drug resistance represents an alarming threat for those achievements. Herein, the available, but relatively scarce and dispersed, information on malaria drug resistance in Angola, is reviewed and discussed. The review aims to inform but also to encourage future research studies that monitor and update the information on anti-malarial drug efficacy and prevalence of molecular markers of drug resistance, key fields in the context and objectives of elimination.
Highlights
Plasmodium falciparum malaria is one of the most important public health problems in Angola, with more than three million cases confirmed between 2000–2013 and 7300 attributed deaths in 2013 [1]
Considerable efforts have been made by the Angolan authorities, which have set a five-fold increase in public financing for malaria control [3]
The country has become a signatory of the Malaria Elimination Eight (E8) network in 2009, aiming to consolidate malaria control and prepare for the ambitious elimination of the disease in the West-Southern African countries [1, 4]
Summary
Plasmodium falciparum malaria is one of the most important public health problems in Angola, with more than three million cases confirmed between 2000–2013 and 7300 attributed deaths in 2013 [1]. Molecular markers of drug resistance The first clinical trials by Guthmann et al showed that the efficacy of all mono-therapies available in Angola was below the minimum benchmark adopted by the World Health Organization (WHO) [19, 33] These findings motivated a number of studies in the following years investigating molecular markers of resistance in the country (Table 2). Gama et al [40] have hypothesized that their exceptional observations were due to imported parasite populations from South America, due to the intense commercial relation between Angola and Brazil and the highly cosmopolitan nature of Luanda Such explanation sounds interesting, it is not supported by the results concerning the analysis of the pfmdr gene in the same parasites (see below). Provinces: Huambo and Bié Type of study: randomized efficacy trial Sampling date: 2004 Participants: 137 children (6–59 months)
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