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  • 1. Epidemiology of Malaria drug-resistant malaria is a rapidly spreading global health threat Malaria is a public health problem today in more than 90 countries, inhabited by 2,400 million people – 40% of the world’s population An estimated 300 to 500 million cases each year cause 1.5 to 2.7 million deaths, more than 90% of which occur in children under age 5 in Africa. Malaria kills one child every 30 seconds Progresses made in the last 50 years in restricting the geographical areas affected by malaria are being eroded recently, due to changes in land use, global climate changes, armed conflicts/movement of refugees, easy international travel and development of multi-drug resistant strains of parasite. The vast majority of areas of endemic malaria show resistance to chloroquine (the oldest, cheapest treatment). Resistance to sulfadoxine-pyrimidine is emerging in most affected areas. Resistence to mefloquine has been observed in South-east Asia (areas of multi-drug resistance) No malaria Malaria present only in small, remote areas. No chloroquine-resistant P.falciparum. Malaria transmision areas Intermediate malaria risk, no chloroquine-resistant strains of P.falciparum. Multidrug resistance areas Intermediate malaria risk, but chloroquine-resistance of P.falciparum is Chloroquine resistance areas conf irmed. Malaria-f ree islands Sulf adoxine –py rimethamine resistance areas High risk area f or chloroquine-resistant Plasmodium falciparum. No clinically relevant resistance has been observed with artemisinin and related derivatives 1
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