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February 3, 2017

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Drug-resistant malaria fuels alarm

AN especially drug-resistant type of malaria is becoming dominant in parts of the Mekong region, researchers said yesterday, warning of potentially dire consequences if it makes the leap to India and Africa.

For the past decade scientists and health workers have become increasingly alarmed by the spread of a malaria strain resistant to artemisinin, a key drug used to treat patients.

The strain was first detected in western Cambodia in 2007 and has since spread to parts of northeastern Thailand, southern Laos and eastern Myanmar.

Now researchers have also discovered a version of that strain that is not only resistant to two types of drugs, but has muscled out its less dangerous peers to become the dominant variant, according to a paper published yesterday in The Lancet Infectious Diseases medical journal.

“What’s happened now is that one lineage which arose in western Cambodia, one family of parasites if you like, has effectively beaten all the rest out and has spread,” said Nicholas White, a specialist from the Mahidol Oxford Tropical Medicine Research Unit in Bangkok, which led the research.

So far the dominant lineage has been detected in parts of Cambodia, Thailand and Laos but not Myanmar — the bridge to South Asia — although researchers believe it is just a matter of time before it pushes westward.

For tropical disease experts, the emergence of this strain has a worrying historical precedent. Last century the borderlands of Cambodia, Thailand and Laos incubated two previous waves of drug-resistant malaria that spread from the region to India and Africa where they killed millions.

The Chinese military came to the rescue when a female chemist discovered artemisinin in the 1970s.

The discovery, coupled with worldwide preventative measures against the mosquitoes, resulted in significant successes made against malaria over recent decades.

But scientists fear much of those gains could unravel if the latest generation of drug-resistant parasites is not tackled.

“There’s been too much talking and not enough doing on this,” warned White.

Arjen Dondorp, the study’s lead author, said a major global effort was needed to stop the latest generation of drug resistant malaria before it heads west.

“Once it is in Africa that would be a disaster because that is where most of the world’s malaria cases are,” he said.




 

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