Since the early 1980s, El Salvador has maintained a substantial decline in malaria incidence. The country is now in the malaria elimination phase, with fewer than 25 cases reported annually since 2011. Analyses indicate that El Salvador’s sustained decline in malaria cases is correlated to interventions and strategies the National Malaria Program implemented earlier and more systematically than neighboring countries.
In 2007, Malawi replaced sulfadoxine-pyrimethamine (SP) with artemisinin-based combination therapy as the first-line treatment for uncomplicated Plasmodium falciparum malaria in response to failing SP efficacy. This study estimates the effect of reduced SP drug pressure on the prevalence of SP-resistant parasites and the characteristics of the associated selective sweeps flanking the resistance loci.