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Artemether + Lumefantrine: A combination currently used as a first-line treatment for malaria

According to a article recently published in the scientific journal Communications Biology, under the leadership (first author) of the Manhiça Health Research Center (CISM) researcher, Clemente da Silva, the current drugs used ​​ to treat and prevent malaria in Mozambique continue to be effective. The article resulted from a study on the resistance of antimalarials in the country, where an analysis and genomic categorization of resistance markers of the Plasmodium falciparum, to medications (Artemisinin, and Fansidar/Sulfadoxine Pyrimethamine -SP , Chloroquine, Piperaquine).

The study was led by the researcher at (ISGlobal) and CISM, Alfredo Mayor, in which his team analyzed and sequenced 2,251 samples of blood infected with P. falciparum collected between 2015 and 2018 in southern, central and northern Mozambique.

The paper's findings have implications for public health in Mozambique

“The findings of this article have several implications for public health in Mozambique. First, the implications for public health in Mozambique. First, that artemisinin derivatives remain effective in the treatment of malaria uncomplicated by P. falciparum. Second, piperaquine can be used in artemisinin combination therapies (ACT). Third, despite the high frequency of gene mutations pfdhfr/dhpsP. falciparum, there is no evidence of reduced chemopreventive efficacy of SP”, comments Clemente da Silva. Also according to da Silva, the data in this article provide premises for studying the evolution of parasites P. falciparum in response to changes in national malaria treatment guidelines.

This study also demonstrated that malaria transmission in Mozambique is very heterogeneous

On the other hand, Alfredo Mayor adds that “in Mozambique, several studies reported the resistance of antimalarials to drugs, but little was known about their geographic distribution, and this study also demonstrated that malaria transmission in Mozambique is very heterogeneous, with a high weight in the north and a very low transmission in the south”, because, according to the study data, the team found a regional differentiation of the parasite, which may be due to several factors, including geographic distance and differences in the use and coverage of antimalarial interventions.

Studies on monitoring the presence and expansion of drug resistance markers is crucial to inform malaria control programs to ensure that the drugs used ​​ remain effective, so this study highlights the need to integrate molecular surveillance systems with drug efficacy studies to track the emergence and spread of drug-resistant parasites.


Clemente da Silva, Simone Boene, Debayan Datta et al. Targeted and whole-genome sequencing reveal a north-south divide in P. falciparum drug resistance markers and genetic structure in Mozambique. Commun. Biol. 2023.

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