LETTER TO THE EDITOR: LATE RECRUDESCENCE OF PLASMODIUM F AL CIP AR UMAFTER ARTEMISININ BASED THERAPY SUGGESTS A NEED FOR PROLONGED FOLLOW UP DURATION

Artemisinin based combination therapies (ACTs) are the corner stone of current efforts aimed at the management and control of malaria globally.1 In 2004, Nigeria adopted the recommendation of the World Health Organization and made two ACTs (artemether- lumfanthrine and artesunate Amodiaquine) the first line malaria therapies. Several studies have confirmed the high efficacies of these therapies.2 However, in 2009, resistance to Artemisin was reported from South-east Asia.3 Since then, fears of resistance to artemisinin in sub-saharan Africa have been entertained. Recent publications from workers in Nigeria are pointing towards a decline in malaria parasite susceptibility to artemisinin-based combination therapies.4 These reports are worrisome and there is a need for inter ventions and methods that will delay the development of artemisinin resistance in the sub region. This letter describes an observation that suggests the need for prolonged follow up of malaria patients after treatment with artemisinin-based therapies in order to monitor properly the pattern of recrudescence to ACT therapies. The following report will contribute to background data and the need for prolonging the follow up period in antimalarial studies that may be essential to the monitoring of recent trends to artemisinin-based therapies in Nigeria.