How "Resistant" Is Artemisinin Resistant Malaria? - The Risks of Ambiguity Using the Term "Resistant" Malaria

Travel Med Infect Dis. Jul-Aug 2018;24:23-24. doi: 10.1016/j.tmaid.2018.04.008. Epub 2018 Apr 30.

Abstract

In scientific discourse, few would consider the widely used term resistance as ambiguous. The definition and usage of the term antimicrobial resistance revolves around the concept that microorganisms change in ways that render antimicrobial medications clinically ineffective. Because artemisinins have become the cornerstone for antimalarial therapy, the widely used term artemisinin resistance in scientific literature is highly alarming. Naturally, many people will assume that artemisinin resistance must essentially be the same as antimicrobial resistance, which means it is clinically ineffective. However, this is incorrect, and the WHO defines artemisinin resistance differently to antimicrobial resistance as "partial/relative resistance". This means that parasite clearance times are increased but does not automatically mean that artemisinins have become clinically inefficacious. Is the ambiguous use of the term resistance justified and appropriate, although it might be misleading biomedical researchers, the media, policy makers and possibly attending physicians? Science is also about clear and unambiguous use of terminology, so that a message is accurately communicated and understood. Ambiguity can lead to misunderstandings, and misunderstandings can cause wrong actions; unnecessarily so.

Keywords: Ambiguity; Antimicrobial resistance; Artemisinin resistance; Definitions.

MeSH terms

  • Antimalarials / adverse effects
  • Antimalarials / pharmacology*
  • Antimalarials / therapeutic use
  • Artemisinins / adverse effects*
  • Artemisinins / pharmacology*
  • Artemisinins / therapeutic use
  • Drug Resistance*
  • Humans
  • Malaria / drug therapy
  • Malaria, Falciparum / drug therapy
  • Plasmodium falciparum / drug effects*
  • World Health Organization

Substances

  • Antimalarials
  • Artemisinins
  • artemisinine