**6. Treatment of malaria cases**

Chloroquine the cheapest anti-malarial drug is no longer prescribed for the treatment of *P. falciparum* malaria cases. Even monotherapy with artemisinin is also not recommended. Currently different ACTs are prescribed for treatment of *P. falciparum* malaria including some *P. vivax* cases. The partner drugs are sulfadoxine-pyrimethamine, piperaquine, lumefantrine, pyrrolidine, etc. In India, chloroquine is still efficacious against *P. vivax* even in the presence of *Pvcrt-0* and *Pvmdr-1* mutations [17]. On the other hand, the presence of *kelch 13* (*k13*) mutations in *P. falciparum* is linked to artemisinin resistance. Recent report from eastern India indicated the presence of two mutations G625R and R539T in 5/72 *P. falciparum* cases treated with artemisinin that linked to its presence of resistance [18]. In Africa, where *P. falciparum* is predominant there is no sign of artemisinin resistance even with more than 200 non-synonymous *k13* mutations recorded. A recent report suggested that artemisinin resistance in a patient can be addressed by changing the partner drugs which is responding to the local parasites [19]. Such combination should be selected for *P. falciparum* treatment. Several studies indicated the absence of S769 N mutation in *Pf*ATPase6 gene responsible for artemisinin resistance [20]. Possibly this marker would be the better one for monitoring of artemisinin resistance in most malaria-endemic settings.
