OBSadvanced

In the context of malaria chemotherapy and treatment outcomes, define each of the following five terms: cure, recurrence, recrudescence, relapse, and drug resistance.

Answer

- Cure: Complete elimination of clinical symptoms and causative asexual blood-stage parasites. - Recurrence: Reappearance of asexual parasitaemia after treatment, which may be caused by recrudescence, relapse, or reinfection. - Recrudescence: Reappearance of asexual parasitaemia resulting from the survival of blood-stage parasites following treatment. - Relapse: Reappearance of asexual parasitaemia resulting from the reactivation of dormant liver hypnozoites in Plasmodium vivax or Plasmodium ovale infections. - Drug resistance: The ability of a parasite strain to survive or multiply despite the administration and absorption of an antimalarial drug given in doses equal to or higher than typically recommended.

Explanation

These definitions distinguish treatment outcome, a broad recurrence category, specific recurrence mechanisms, and failure of drug susceptibility. **Key takeaway:** Recurrence does not by itself prove drug resistance; its cause must be considered.\n\n**Glossary:** **Asexual parasitaemia**: asexual parasites present in blood; **drug resistance**: ability to survive or multiply despite adequate effective treatment.

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