{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T08:44:45Z","timestamp":1790239485129,"version":"4.1.0"},"reference-count":38,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,3,5]]},"abstract":"<jats:p>The emergence of artemisinin-resistant <jats:italic>Plasmodium falciparum<\/jats:italic> in the Greater Mekong Subregion threatens both the efficacy of artemisinin-based combination therapy (ACT), the first-line treatment for malaria, and prospects for malaria elimination. Monitoring of ACT efficacy is essential for ensuring timely updates to elimination policies and treatment recommendations. In 2014\u20132015, we assessed the therapeutic efficacies of artemether\u2013lumefantrine (AL) and dihydroartemisinin\u2013piperaquine (DP) for the treatment of uncomplicated <jats:italic>P. falciparum<\/jats:italic> at three study sites in Rakhine, Shan, and Kachin states in Myanmar. Patients presenting with uncomplicated <jats:italic>P. falciparum<\/jats:italic> malaria were enrolled, treated, and followed up for 28 days for AL or 42 days for DP. Both AL and DP demonstrated good therapeutic efficacy at all three study sites. The 28-day cure rate for AL was &gt; 96% across all study sites, and the 42-day cure rate for DP was 100%. Parasitemia on day 3 was detected in 0%, 3.3%, and 3.6% of participants treated with AL at the Rakhine, Shan, and Kachin sites, respectively. No participants treated with DP were parasitemic on day 3. No evidence of <jats:italic>P. falciparum k13<\/jats:italic> mutations was found at the Rakhine study site. A high prevalence of <jats:italic>k13<\/jats:italic> mutations associated with artemisinin resistance was observed at the Kachin and Shan state study sites. These results confirm that ACT efficacy has been resilient in therapeutic efficacy study (TES) sentinel sites in Myanmar, despite the presence at some sites of <jats:italic>k13<\/jats:italic> mutations associated with resistance. Studies are ongoing to assess whether this resilience persists.<\/jats:p>","DOI":"10.4269\/ajtmh.19-0692","type":"journal-article","created":{"date-parts":[[2019,12,13]],"date-time":"2019-12-13T07:00:44Z","timestamp":1576220444000},"page":"598-604","source":"Crossref","is-referenced-by-count":11,"title":["Artemether\u2013Lumefantrine and Dihydroartemisinin\u2013Piperaquine Retain High Efficacy for Treatment of Uncomplicated Plasmodium falciparum Malaria in Myanmar"],"prefix":"10.4269","volume":"102","author":[{"given":"Kay Thwe","family":"Han","sequence":"first","affiliation":[{"name":"Department of Medical Research, Myanmar Ministry of Health and Sports, Yangon, Myanmar;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khin","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Medical Research, Myanmar Ministry of Health and Sports, Yangon, Myanmar;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moe Kyaw","family":"Myint","sequence":"additional","affiliation":[{"name":"Department of Medical Research, Myanmar Ministry of Health and Sports, Yangon, Myanmar;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aung","family":"Thi","sequence":"additional","affiliation":[{"name":"National Malaria Control Program, Myanmar Ministry of Health and Sports, Nay Pyi Taw, Myanmar;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyin Hla","family":"Aye","sequence":"additional","affiliation":[{"name":"Department of Medical Research, Myanmar Ministry of Health and Sports, Yangon, Myanmar;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zay Yar","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Medical Research, Myanmar Ministry of Health and Sports, Yangon, Myanmar;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mya","family":"Moe","sequence":"additional","affiliation":[{"name":"Department of Medical Research, Myanmar Ministry of Health and Sports, Yangon, Myanmar;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Dorina","family":"Bustos","sequence":"additional","affiliation":[{"name":"World Health Organization, Bangkok, Thailand;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Md Mushfiqur","family":"Rahman","sequence":"additional","affiliation":[{"name":"World Health Organization, Yangon, Myanmar;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pascal","family":"Ringwald","sequence":"additional","affiliation":[{"name":"Global Malaria Programme, World Health Organization, Geneva, Switzerland;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan","family":"Simmons","sequence":"additional","affiliation":[{"name":"Duke Global Health Institute, Duke University, Durham, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine F.","family":"Markwalter","sequence":"additional","affiliation":[{"name":"Duke Global Health Institute, Duke University, Durham, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher V.","family":"Plowe","sequence":"additional","affiliation":[{"name":"Duke Global Health Institute, Duke University, Durham, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Myaing M.","family":"Nyunt","sequence":"additional","affiliation":[{"name":"Duke Global Health Institute, Duke University, Durham, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"b1","series-title":"World Malaria Report 2017","author":"World Health Organization","year":"2017"},{"key":"b2","series-title":"PLoS Med","first-page":"e1000290","article-title":"Estimating the global clinical burden of Plasmodium falciparum malaria in 2007","volume":"7","author":"Hay","year":"2010"},{"key":"b3","series-title":"Malar J","first-page":"503","article-title":"Malaria incidence in Myanmar 2005\u20132014: steady but fragile progress towards elimination","volume":"15","author":"Mu","year":"2016"},{"key":"b4","series-title":"World Malaria Report 2018","author":"World Health Organization","year":"2018"},{"key":"b5","series-title":"J Infect Dis","first-page":"670","article-title":"Independent emergence of artemisinin resistance mutations among Plasmodium falciparum in southeast Asia","volume":"211","author":"Takala-Harrison","year":"2015"},{"key":"b6","series-title":"N Engl J Med","first-page":"2453","article-title":"A worldwide map of Plasmodium falciparum K13-propeller polymorphisms","volume":"374","author":"M\u00e9nard","year":"2016"},{"key":"b7","series-title":"National Strategic Plan - Malaria Prevention and Control 2010\u20132016","author":"Myanmar Ministry of Health","year":"2014"},{"key":"b8","series-title":"Clin Infect Dis","first-page":"784","article-title":"Declining efficacy of artemisinin combination therapy against P. 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