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Table 1 Artemisinin-based combination therapies used in Africa

From: Evaluation of residual submicroscopic Plasmodium falciparum parasites 3 days after initiation of treatment with artemisinin-based combination therapy

Artemisinin-based combination therapyArtemisinin componentPartner drugPartner drug targetPresence of persistent submicroscopic parasites on day 3 after treatmentValidated marker of drug resistance
Artemether-lumefantrineArtemetherLumefantrineInterferes with haem detoxificationYes [17, 19,20,21, 25, 86]pfmdr1 N86, 184F, D1246
Amplification of pfmdr1 copy number
pfcrt K76
Haplotype CVMNK [24, 48, 87, 88]
Artesunate-amodiaquineArtesunateAmodiaquineInterferes with haem detoxificationYes [89]pfmdr1 86Y, Y184, 1246Y
pfcrt 76T
Haplotype SVMNT [24, 87]
Inhibits two enzymes involved in folate biosynthesis pathways. Sulfadoxine inhibits dihydropteroate synthase (dhps), and Pyrimethamine inhibits dihydrofolate reductase (dhfr) [90, 91]Yes [90]pfdhfr 51I, 59R, 108 N
pfdhps 437G, 540E [24, 90, 91]
Dihydroartemisinin-piperaquineDihydroartemisininPiperaquineNot well understood but linked to inhibition of haem degradation pathwaysYes [17]Plasmepsin II and III amplification [24, 88]
Artesunate-pyronaridine (Registered and in use in some countries [23])ArtesunatePyronaridineInterferes with haem detoxificationYes [25]pfcrt 76T [24]