Artemisinin Partial Resistance in Ugandan Children—Reply

In Reply We read with interest the Letter from Dr Weathers and colleagues in response to our recent Research Letter in JAMA. The possibility of using whole-plant preparations of Artemisia species is worth pursuing if such use holds promise as a cost-effective and potent antimalarial chemotherapy strategy. It is plausible that additional Artemisia phytochemicals not present in purified artemisinin preparations can synergize with the endoperoxides to enhance antimalarial benefits. The evidence from these authors that such preparations slow the evolution of reduced susceptibility to artemisinin in the rodent malaria Plasmodium yoelii is also intriguing. However, drug selection of P yoelii with artemisinins often produces phenotypes that are not readily heritable and have no well-established genetic basis. Therefore, this model does not suffice as a source of insights into reduced artemisinin susceptibility of P falciparum in humans.