Health Care

Drug-resistant malaria parasites 'spreading aggressively' across south-east Asia

Drug-resistant malaria parasites 'spreading aggressively' across south-east Asia”

The parasites have acquired new mutations and have produced an even higher level of resistance, allowing their proliferation and spread across the Greater Mekong Subregion.

Additionally, the study noted that 80% of the most prevalent malaria parasite were now resistant to the two most common anti-malarial drugs.

Nearly 220 million people were infected with malaria in 2017, according to World Health Organisation estimates, and the disease killed 400,000 of them.

Malaria can be treated with medicines if caught early enough, but evolving drug-resistance - such as the spread of chloroquine-resistant malaria across Asia to Africa from the late 1950s to the 1980 - has hampered efforts to eliminate it.

The drug, (DHA-PPQ) dihydroartemisinin-piperaquine, has now reached a 62% failure rate in western Cambodia, 27% in northeastern Cambodia, 53% in southwestern Vietnam, and 87% in northeast Thailand, researchers stated in a statement. However, a previous study identified a strain of malaria that had become resistant to this treatment.

The commentary, 'Accelerated evolution and spread of multidrug-resistant Plasmodium falciparum takes down the latest first-line antimalarial drug in southeast Asia.Plasmodium falciparum takes down the latest first-line antimalarial drug in southeast Asia,' can be read in The Lancet Infectious Diseases. It is responsible for nine in 10 malaria deaths worldwide and 200 million of the 217 million malaria infections reported in 2017. Their analysis, focusing on the KEL1 and PLA1 gene variants, revealed that the situation had got much worse after 2013.

Strains of malaria resistant to two key anti-malarial medicines are becoming more dominant in Vietnam, Laos and northern Thailand after spreading rapidly from Cambodia, scientists warned on Monday.

As the results of the other study show, the spread of KEL1/PLA1 is having a demonstrably negative impact on malaria treatment in the region.

"This extremely a success resistant parasite rigidity is ready to invading contemporary territories and procuring contemporary genetic properties, raising the gruesome prospect that it will per chance probably presumably well well unfold to Africa, where most malaria cases occur, as resistance to chloroquine did in the 1980s, contributing to thousands and thousands of deaths", Prof Olivo Miotto, from the Wellcome Sanger Institute and College of Oxford, acknowledged. These parasites had then rapidly spread across borders.

The researchers also found that the risk of treatment failure was strongly associated with crt mutations, and that the prevalence of these mutations had risen substantially.

'Southeast Asia is the cradle of antimalarial drug resistance.

Dr Michael Chew, Infection and Immunobiology Portfolio Manager at Wellcome said: "This study clearly shows the rapid spread of multi-drug resistant malaria across Southeast Asia". Protecting the efficacy of the recommended malaria treatments is a top priority for malaria-endemic countries and the global malaria community. It serves as a reminder that we must not show complacency with the response to malaria. However, the development of drug resistance threatens that progress.

Professor Dominic Kwiatkowski, a senior author on the paper from the Wellcome Sanger Institute and the Big Data Institute at University of Oxford, said: "Our study provides a clear picture of how malaria that is resistant to the first-line treatment is spreading, and demonstrates the importance of using genetics to detect patterns of resistance in each area".



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