Resistant malaria parasite in Southeast Asia

Common drugs are no longer effective in resistant malaria pathogens

01/08/2014

According to the World Health Organization (WHO), malaria kills more than 600,000 people each year. Of these, about 90 percent are children under the age of five in Africa. After the number of deaths has been significantly reduced in recent years, medicine now has a major setback in the fight against the disease recorded: In Southeast Asia is currently spreading a malaria pathogen, which is resistant to all common drugs. If the pathogen also spreads in Africa, it could cost the lives of countless people.

So far, resistant malaria pathogens are limited to Southeast Asia
In some regions of Thailand, Cambodia, Myanmar and Vietnam, the malaria-resistant against standard drugs malaria pathogens have already firmly established, report researchers from the British Oxford University and Mahidol University in Thailand in the journal „New England Journal of Medicine. "Resistant pathogens have spread from the Cambodian-Thai border region before, and there is great concern in a statement from Oxford University. „If the resistance spreads from Asia to Africa, much of the great progress in reducing deaths from malaria would have been reversed, "said Jeremy Farrar, director of the charitable Wellcome Trust.

„It may still be possible to halt the spread of the artemisinin-resistant malaria parasites in Asia and Africa by eliminating them, but this window of opportunity will close quickly“, explains the lead author of the study, Professor Nicholas White of Oxford University. „Conventional approaches to combating malaria will not be enough - we will have to resort to more radical measures and make the problem a global public health priority - without delay.“

Doubling the treatment duration of standard antimalarial therapy
The researchers came up with the resistant pathogen when they examined more than 1,200 patients from ten countries in Asia and Africa between May 2011 and April 2013. As it turns out, the pathogen Plasmodium falciparum, which causes the dangerous malaria tropica, is often no longer sensitive to the standard procedure with artemisinin combined therapy (ACT) in Southeast Asia. However, in the three African countries, Kenya, Nigeria and the Democratic Republic of the Congo, from which patients were examined, the researchers found no such resistance. In the short term, doubling the treatment time to six days could be a solution, the researchers write in the study.

Resistance can develop, for example, if the drug treatment is stopped too early. Then not all malaria parasites are killed and the parasites can mutate so that they become immune to the drug. In the past, such resistances have often been observed, albeit to a lesser extent.

„The standard ACT is still very effective in treating most patients. But we need to be vigilant as cure rates have dropped in areas with artemisinin resistance“, explains Elizabeth Ashley of the Mahidol Oxford Tropical Medicine Research Unit (MORU). „Action is urgently needed to prevent the spread of Myanmar resistance to neighboring Bangladesh and India.“ (Ag)