Abstract

Background:


Falciparum malaria accounted for 99% of cases in Africa, 77% in the Western Pacific Region, 66% in Southeast Asia, 58% in the Eastern Mediterranean Region, and 36% in America of the anticipated 216 million cases of the disease in 2016. The use of artemisinin-based combination therapies (ACTs), which combine an artemisinin derivative with a partner drug, in the treatment of uncomplicated malaria has largely been responsible for the significant reduction in malaria-related mortality in Nigeria. ACTs have played a significant role in the 18% decline in the incidence of malaria cases from 2010 to 2016. However, this progress is seriously threatened by the reduced clinical efficacy of artemisinins, which is characterised by delayed parasite clearance and a high rate of recrudescence, as reported in 2008 in Western Cambodia. Furthermore, resistance to partner drugs has been shown in some instances to be facilitated by pre-existing decreased susceptibility to the artemisinin component of the ACT. A major concern is not only the spread of these multidrug-resistant parasite in Nigeria but also their possible appearance in Sub-Saharan Africa the continent most affected by malaria, as has been the case in the past with parasite resistance to other antimalarial treatments.


Conclusion


It is therefore essential to understand the factors that are implicated in the possible development of ACT drug resistance, the underlying mechanisms and regulations that can reduce the development and spread of ACT resistance in Nigeria