Malaria

Global database on antimalarial drug efficacy and resistance

Last update: 20 June 2017

The global database on antimalarial drug efficacy and resistance was initiated in 2000 to centralize data and facilitate reporting on the status of antimalarial drug efficacy in malaria endemic countries. The contents of the database are extracted from published and non-published therapeutic efficacy studies (TES) conducted by ministries of health, national malaria control programmes, research institutes and NGOs.

The database is the source for the therapeutic efficacy studies summary tables, the antimalarial drug efficacy maps, the Global report on antimalarial drug efficacy and drug resistance, and the updates on artemisinin and artemisinin-based combination therapy (ACT) resistance.

Initially, the database focused on TES conducted on Plasmodium falciparum. Over time, it has been extended to include TES on all malaria species, as well as studies on molecular markers.

Therapeutic efficacy study data

The database includes TES conducted in accordance with the WHO standard protocol for monitoring antimalarial drug efficacy. Since study duration often extends over 2 calendar years, the year in the database refers to the year in which the study began. Studies have a minimum follow-up period of 28 days, with polymerase chain reaction (PCR)-correction to distinguish between treatment failures caused by reinfection from those caused by recrudescence.

Treatment failure rates are calculated using the per-protocol method. This analysis includes only patients who complete the entire study follow-up and have a clear outcome of either treatment success or failure. Patients who do not complete follow-up, deviate from the study protocol, or withdraw, are excluded from the analysis. Treatment failure rates using the Kaplan-Meier analysis are provided when available.

Data from the most recent TES are summarized in the tables below. The summary tables provide treatment failure rates grouped by treatment and country.

Therapeutic efficacy study results - P. falciparum
Therapeutic efficacy study results - P. vivax
Therapeutic efficacy study results - P. knowlesi

TES results are also available through interactive maps. These maps provide a visual overview of the status of antimalarial drug efficacy in malaria endemic countries.

Molecular markers of antimalarial drug resistance data

The database also includes data on the geographical distribution of molecular markers associated with P. falciparum drug resistance, including: PfKelch 13, Pfplasmepsin 2-3, Pfmdr1, Pfcytochrome b and Pfcrt in Mesoamerica. Maps will be made available online in 2017.

For comparability purposes, the Institut Pasteur in Cambodia prepared 2 sets of procedures intended for use in clinical trials and molecular studies.

Global report on antimalarial drug efficacy and drug resistance

The Global report on antimalarial drug efficacy and drug resistance provides a comprehensive, global overview of antimalarial drug efficacy and the resistance of malaria parasites to antimalarial medicines.

Updates on artemisinin and ACT resistance

The updates bring together the latest findings and conclusions about the state of resistance to artemisinins and ACT, summarize WHO’s current policy and treatment recommendations, and highlight areas of concern.

Key documents