Malaria resistance grows

As drug resistance grows in the malaria parasite, the medical fraternity is challenged to find new, innovative cures while adequate housing is a good solution.
Yanna Smith
For the first time in Africa, researchers announced that they have detected a malaria parasite that is partially resistant to the top anti-malaria drug, artemisinin, raising concern about efforts to fight a disease that sickens hundreds of millions of people each year.

The discovery means that Africa now joins southeast Asia in hosting such drug-resistant forms of the mosquito-borne disease.

Malaria infected more than 200 million people and killed some 438 000 people worldwide in 2015, most of them children in Africa.

“The spread of artemisinin resistance in Africa would be a major setback in the fight against malaria, as ACT (artemisinin-based combination therapy) is the only effective and widely used antimalarial treatment at the moment,” said lead author Arnab Pain, professor at the King Abdullah University of Science and Technology.

“Therefore, it is very important to regularly monitor artemisinin resistance worldwide.”

The drug-resistant malaria parasites were detected in a Chinese patient who had travelled from Equatorial Guinea to China, said the report led by Jun Cao from the Jiangsu Institute for Parasitic Diseases in China.

The study was published in the New England Journal of Medicine.

Combination therapy with artemisinin usually clears malaria from the blood in three days.

In southeast Asia, strains of the malaria-causing agent, Plasmodium falciparum, have grown relatively tolerant to artemisinin, in what is known as “partial resistance.”

Most patients can still be cured, but it takes longer. World Health Organisation experts are concerned that P. falciparum could eventually become completely resistant to artemisinin, just as it has to other antimalarial drugs, including quinine. Researchers said they found the parasite carried a new mutation in a gene called Kelch13 (K13), which is the main driver for artemisinin resistance in Asia. They then confirmed the origin of the resistance was Africa, by using “whole-genome sequencing and bioinformatics tools we had previously developed - like detectives trying to link the culprit parasite to the crime scene,” he said. Malaria becomes a risk at this time of the year with standing water after good rainfall which in turn breeds mosquitoes.

The onset of malaria is very similar to a bad cold with profound headaches and body aches. Other symptoms to watch out for include shaking chills that can range from moderate to severe, high fever, profuse sweating, nausea and vomiting. Diarrhoea and anaemia can also occur.



Good housing

In the meanwhile, researchers have found a link between modern houses and a reduction in the odds of children contracting malaria in sub-Saharan Africa, according to a study released Wednesday by the University of Oxford.

Insecticide-treated bednets and house spraying have been effective in reducing the prevalence of malaria since the turn of the 21st century, but other approaches are needed to eliminate the mosquito-transmitted, parasitic disease. Modern houses, with metal roofs and finished walls, are thought to be a better protection against the parasite compared with the traditional thatched houses. In this study, a team led by University of Oxford researchers analysed data on malaria prevalence and housing using data collected in 29 surveys carried out in 21 African countries between 2008 and 2015. Information on malaria status was available for 139 318 children under the age of five living in 84 153 households.

Across all surveys, modern housing was associated with a 9 to 14% reduction in the odds of malaria infection, according to the study.

Well-built housing can block mosquitoes from entering homes and prevent them from transmitting malaria to the people who live there, explained Lucy Tusting from the University of Oxford, who is the lead author of the study.

“This is a welcome finding at a time when we are facing increasing resistance to our most effective insecticides and drugs,” said Tusting.

But the authors also cautioned that the effectiveness of improving housing varied depending on the location.

The study has been published in the journal PLOS Medicine.







NAMPA/XINHUA

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