Malaria Parasite Clearance: What Are We Really Measuring?

Trends Parasitol. 2020 May;36(5):413-426. doi: 10.1016/ Epub 2020 Mar 21.


Antimalarial drugs are vital for treating malaria and controlling transmission. Measuring drug efficacy in the field requires large clinical trials and thus we have identified proxy measures of drug efficacy such as the parasite clearance curve. This is often assumed to measure the rate of drug activity against parasites and is used to predict optimal treatment regimens required to completely clear a blood-stage infection. We discuss evidence that the clearance curve is not measuring the rate of drug killing. This has major implications for how we assess optimal treatment regimens, as well as how we prioritise new drugs in the drug development pipeline.

Keywords: drug development; drug efficacy; malaria; parasite clearance; viability.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Antimalarials / pharmacology
  • Antimalarials / therapeutic use*
  • Humans
  • Malaria, Falciparum / drug therapy*
  • Malaria, Falciparum / parasitology*
  • Parasitemia / drug therapy
  • Parasitemia / parasitology
  • Plasmodium falciparum / drug effects
  • Plasmodium falciparum / physiology
  • Treatment Outcome


  • Antimalarials