Malaria in the horn of Africa: The ongoing battle against drug resistance

Malaria remains a major global health issue, especially in sub-Saharan Africa, with increasing cases and deaths reported in recent years. The effectiveness of malaria treatment is threatened by the emergence of antimalarial drug resistance. The emergence and spread of parasites with artemisinin partial resistance (ART-R) and genome modifications that prevent their detection by rapid diagnostic tests (RDTs) in the Horn of Africa is worrying. This threatens malaria control and elimination campaigns. Past efforts to eradicate malaria have failed due to drug resistance. Adaptable, region-specific strategies for malaria control are needed.

• 1
  Artemisinin-resistant malaria is increasing in the Horn of Africa and is coupled with the spread of parasites undetectable by standard rapid diagnostic tests.
• 2
  The Pfkelch13 622I artemisinin-resistant variant, combined with Pfhrp2/3 gene deletions, is making parasite strains difficult to detect using HRP2-based RDTs.
• 3
  Malaria vectors in the Horn of Africa are becoming resistant to insecticides, and Anopheles stephensi can transmit these strains in urban environments.