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Background: This study investigates the processes regarding changing malaria treatment policies in Vietnam. Moreover, it explores the feasibility of introducing triple artemisinin-based combination therapy (TACT) in Vietnam to support the national malaria control and elimination plan.
Methods: Data were collected via 12 in-depth interviews with key stakeholders, combined with a review of policy documents.
Results: TACT is considered as a useful backup strategy in case future treatment failures with current artemisinin-based combination therapy (ACT) would occur. Moreover, TACT is also considered as a promising strategy to prevent the re-establishment of malaria. However, regulatory procedures and implementation timelines for TACT were expected to be lengthy. Therefore, strategies to engage national decision-makers, regulators, and suppliers should be initiated soon, stipulating the benefits of TACT deployment. In Vietnam, a procedure to apply for an import permit without registration that has previously been applied to the introduction of artesunate-pyronaridine was proposed to accelerate the introduction of TACT. Global-level support through the World Health Organization recommendations and prequalification were considered critical for supporting the introduction of TACT in Vietnam.
Conclusions: Appropriate approach strategies and early stakeholder engagement will be needed to accelerate the introduction of TACT in Vietnam.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10613363 | PMC |
http://dx.doi.org/10.1186/s12936-023-04763-4 | DOI Listing |
Mol Biochem Parasitol
September 2025
NyBerMan Bioinformatics Europe, Paddenstoelenlaan 8, 3451 PZ Utrecht, Netherlands.
The emergence of multidrug resistance in Plasmodium falciparum poses a serious threat to antimalarial treatment, particularly with growing resistance to artemisinin-based combination therapies (ACTs) and partner drugs like piperaquine. Mutations in key proteins, such as PfCRT (P. falciparum chloroquine resistance transporter) and PfDHFR (P.
View Article and Find Full Text PDFbioRxiv
August 2025
Division of Infectious Diseases, Washington University School of Medicine, Saint Louis, MO United States of America.
Artemisinin-based combination therapies (ACTs) remain the mainstay of treatment for malaria, despite reports of ACT treatment failure. ACTs consist of an artemisinin and a longer-lived partner drug, which is often a quinoline. Given that heme is central to the mechanism of action of artemisinins and some quinolines, we hypothesized that these antimalarials would exhibit strong drug-drug interactions.
View Article and Find Full Text PDFInt J Infect Dis
August 2025
Rwanda Biomedical Centre, Kigali, Rwanda. Electronic address:
Malaria remains a significant public health concern in Africa, with the efficacy of Artemisinin-based combination therapies (ACTs) being threatened by the emergence of Plasmodium falciparum (Pf) kelch13 mutations. The current genetic diversity of Pf and associated contributing factors reported in Africa between 2019 and 2024 were reviewed. It was shown that validated kelch13 mutations are mainly distributed in East African regions, particularly in Eritrea (R622I, 68%) and Uganda (R561H, 52%).
View Article and Find Full Text PDFNat Commun
August 2025
Laboratory of Molecular Parasitology, State Key Laboratory of Cardiology and Research Center for Translational Medicine, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, China.
Artemisinin and its semisynthetic derivatives (ART) are crucial medicines in artemisinin-based combination therapies worldwide. Despite ART's efficacy, small proportions of young intraerythrocytic ring stage parasites can survive the drug's short half-life, and dormant forms can cause recrudescence if not cleared by partner drugs. Certain mutations in the Kelch propeller region of P.
View Article and Find Full Text PDFLancet Infect Dis
August 2025
Infectious Diseases Research Collaboration, Kampala, Uganda; Department of Disease Control and Environmental Health, Makerere University, Kampala, Uganda.
Background: Anti-malarial artemisinin-based combination therapies (ACTs) might be losing efficacy in east Africa, with the spread of artemisinin partial resistance and reduced partner drug activity. Our trial aimed to measure the efficacies of artemether-lumefantrine, artesunate-amodiaquine, dihydroartemisinin-piperaquine, and artesunate-pyronaridine in three sites in Uganda.
Methods: This randomised, open-label, phase 4 clinical trial was carried out at three sites in the Agago, Arua, and Busia districts of Uganda.