Antimalarial Drug Resistance: A Synthesis of Evidence

Tom Robert

Department of Clinical Medicine and Dentistry, Kampala International University Uganda

Email: robert.tom@studwc.kiu.ac.ug

ABSTRACT

Malaria remains a major public health challenge, disproportionately affecting low- and middle-income countries, particularly in sub-Saharan Africa. Although significant progress has been achieved through vector control strategies and artemisinin-based combination therapies (ACTs), the spread of drug-resistant Plasmodium strains threatens malaria control and elimination efforts. Resistance to chloroquine, sulfadoxine-pyrimethamine, and, more recently, artemisinin and its partner drugs has been documented across endemic regions, driven by genetic mutations, drug pressure, and inadequate dosing. The emergence of artemisinin resistance, associated with mutations in the kelch13 (K13) propeller domain, is of particular concern given the reliance on ACTs as first-line therapy. This review synthesizes evidence on the history, mechanisms, and epidemiology of antimalarial drug resistance. It also discusses factors contributing to resistance, current therapeutic strategies, and the urgent need for surveillance, novel antimalarials, and integrated approaches to sustain malaria control and move toward elimination.

Keywords: Malaria; Antimalarial drugs; Drug resistance; Artemisinin; Plasmodium falciparum; and Public health.

CITE AS: Tom Robert (2025). Antimalarial Drug Resistance: A Synthesis of Evidence. RESEARCH INVENTION JOURNAL OF SCIENTIFIC AND EXPERIMENTAL SCIENCES 5(3):14-25. https://doi.org/10.59298/RIJSES/2025/5311425