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To our knowledge this is the first study to investigate the presence of five antimalarials (CQ, SDX, PYR, QN and MQ) in blood of patients from Chhattisgarh, Madhya Pradesh, Jharkhand and Odisha with Pf malaria before the onset of treatment. Out of these five antimalarial drugs, CQ is currently recommended as first line antimalarial for uncomplicated P. vivax (Pv) malaria cases in the country, while SP is being recommended as partner drug in the recommended ACT for the treatment of uncomplicated Pf malaria throughout the country except in the north-eastern India. QN is recommended as rescue for case where treatment failure cases to ACT is observed while MQ is advised for long term chemoprophylaxis. The measurement of these five antimalarials allowed a comprehensive assessment of the circulating drugs in the community under study. Malaria is a major public health problem in India and its dynamics vary from place to place. The forest and tribal areas of Madhya Pradesh, Chhattisgarh, Jharkhand & Odisha where malaria outbreaks are frequently recorded. Both Pf and Pv are prevalent species in these states with a preponderance of Pf. Drug resistance is a major problem for control and eradication of malaria. Besides the genetic factors, drug pressure in the community also plays a major role in emergence of drug resistant parasites (Hodel et al. 2009). To assess the drug pressure, residual level of antimalarials was monitored by HPLC in the patients enrolled at selected study sites under therapeutic efficacy studies. We found that out of 295 patients enrolled in our study, 70 (24.2%) carried blood residual antimalarials above the lower limit of detection (50 ng/ml) at inclusion (Hodel et al. 2010) This could be a worrying factor and a possible indication of tolerance to residues which could act as a precursor for the development precipitation of resistance. This is a matter of concern and the issue needs to be carefully monitored at state as well as national level.>