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Multi-drug resistance in malaria under combination therapy: Assessment of specific markers and development of innovative, rapid and simple diagnostics
Framework programme:
Contract/Grant agreement number:
EC contribution:
2,800,000 €
60 months
Funding scheme:
Focused Research Project
Starting date:

Keywords: malaria, drug resistance, artemisinin-based combination therapy, diagnostics, molecular biology, Plasmodium, rapid tests.


Malaria is the most serious parasitic disease in the world. Approximately one-fourth of the world's population is at risk of contracting the disease, and every year more than 2 million people, mainly young children in sub-Saharan Africa, die because of it. Malaria is caused by single-cell (protozoan) parasites of the genus Plasmodium. Four species can cause human disease: P. falciparum (the most important one and responsible for the majority of deaths), P. vivax, P. ovale and P. malariae. Accurate diagnosis followed by prompt and efficacious treatment is the backbone of any malaria control programme. However, both diagnosis and treatment represent huge challenges, as many laboratory tests to confirm malaria infection lack sensitivity/specificity or are difficult to perform under rural conditions. Most affordable drugs are also losing their effectiveness due to emerging resistance.

Improved diagnostic tools to support the clinical suspicion of malaria are needed. In principle, molecular biology-based tools would provide the most sensitive and accurate tools for diagnosis, but their implementation in resource-poor settings is hampered due to dependency on electricity, and costs of equipment. To circumvent resistance, the World Health Organization recommends for P. falciparum malaria the use of combination therapies, preferably those containing artemisinin derivatives (ACTs – artemisinin-based combination therapies). However, the use of ACTs requires careful monitoring as there is a significant risk of parasites also developing resistance to this new generation of drugs, leaving vulnerable communities without appropriate treatment measures.

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