Most studies that assess efficacy of antimalarial drugs focus on the outcome of clinical treatment. However, community surveys of surrogate indicators are often more practical and can provide a wider view of possible changes in drug response, but it has not been clear whether assessment of parasite isolates from patients and asymptomatic individuals are directly comparable. In the present work, we have compared the prevalence of molecular markers associated with resistance to sulfadoxine-pyrimethamine in parasites isolated from asymptomatic and symptomatic individuals.
Transmission of malaria has declined in several regions of the world and renewed the interest in malaria elimination. This relative success relied mostly on the scale-up of interventions; the improvement of diagnostic testing by the use of parasitological confirmation of a case and a willingness to improve burden estimates by better defining the populations at risk were both important. In high transmission settings, interventions most often focus on children under 5 who have not yet developed immunity, and pregnant women. However, the burden of infection is most often highest in asymptomatic children between 5-15.
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