"The rapid decline in effectiveness of a widely used anti-malaria drug treatment on the Thai-Burmese border is linked to the increasing prevalence of specific mutations in the malaria parasite itself, according to a paper published in the Clinical Infectious Disease Journal. The mutations in specific regions of the parasite?s kelch gene — which are genetic markers of artemisinin resistance — were the decisive factor, the authors say, in the selection of parasites that are also resistant to mefloquine. This resulted in the growing failure of the widely-used anti-malaria drug combination of mefloquine and artesunate, the first artemisinin combination therapy (ACT) used on the Thai-Burmese border. Led by Dr Aung Pyae Phyo of the Shoklo Malaria Research Unit (SMRU), the study used data from a 10-year study of 1,005 patients with uncomplicated P. falciparum malaria at SMRU clinics on the border. ?This study demonstrates for the first time that artemisinin resistance leads to failure of the artemisinin partner drug, in this case, mefloquine,” says Prof François Nosten, director of SMRU. ?This means that the first line artemisinin combination therapy introduced here in 1994 has finally fallen to resistance,” he said..."