Geographic Differences in Antimalarial Drug Efficacy in Uganda Are Explained by Differences in Endemicity and Not by Known Molecular Markers of Drug Resistance

Abstract

The risk of treatment failure was inversely proportional to transmission intensity and was not explained by differences in molecular markers of antimalarial drug resistance. Our findings strongly suggest that geographic differences in response to antimalarial therapy in Uganda are primarily mediated by acquired immunity associated with malaria transmission intensity, rather than by parasite factors.