Advance of resistant malaria 'poses serious global threat'

Date: Feb-20-2015Researchers who found resistant malaria in samples from Myanmar say it is

moving at an alarming pace across Asia. They call for a more vigorous international

effort to stop it crossing to neighboring India and turning into a serious global

threat.

Malaria samples collected in and around Myanmar contained evidence of resistance to the frontline

drug artemisinin.

In The Lancet Infectious Diseases, the team reports how samples

collected in and around Myanmar contained evidence of resistance to the frontline

drug artemisinin.

The researchers warn that if the resistant parasite spreads into

neighboring India, it would pose a serious threat to the global control and

eradication of malaria.

The warning is a reminder of what happened 50 years ago when malaria resistant to

the drug chloroquine emerged in Asia, spread from Myanmar to India and then to the

rest of the world, claiming millions of lives in its wake.

"The new research shows that history is repeating itself with parasites resistant

to artemisinin drugs, the mainstay of modern malaria treatment, now widespread in

Myanmar," says Prof. Mike Turner, head of infection & immunobiology at the

Wellcome Trust in the UK, one of the study sponsors.

"We are facing the imminent threat of resistance spreading into India, with

thousands of lives at risk," he adds.

Resistant malaria found 25 km from the Indian border

For the study, the researchers, including senior author Dr. Charles Woodrow from

Oxford University in the UK, tested nearly a thousand malaria parasite samples

collected at 55 malaria treatment centers across Myanmar and its border regions.

The team found 39% of samples carried genetic evidence of resistance to artemisinin.

They also confirmed resistant parasites were present in samples taken from centers

located only 25 km from the Indian border.

The authors note how the discovery of the K13 genetic marker in the malaria

parasite Plasmodium falciparum "has transformed approaches to the

monitoring of artemisinin resistance, allowing introduction of molecular

surveillance in remote areas through analysis of DNA."

The rapid collection of samples, even from remote locations, coupled with the

ability to test immediately for K13, gives the team a unique opportunity generate

near "real-time" information on the spread of resistance. Dr. Woodrow

explains:

"With artemisinins, we are in the unusual position of having molecular markers for

resistance before resistance has spread globally. The more we understand about the

current situation in the border regions, the better prepared we are to adapt and

implement strategies to overcome the spread of further drug resistance."

'Real-time' mapping of resistant malaria spread anticipates likely routes

The team has produced maps of the region that show the predicted extent of

artemisinin resistance based on the rate of K13 mutations in the samples collected

from the various sites.

The maps suggest in large areas of East and North of Myanmar - including

areas close to the border with India - more than 10% of malaria parasite is of the

resistant type.

Having near real-time information on malaria drug resistance helps predict the

routes it is likely to take so threatened countries can prepare their national and

regional treatment strategies.

With such information, they can review their medicine dosing - especially for

vulnerable groups such as children and pregnant women - and thereby preserve the

lifespan of life-saving drugs.

Co-author Prof. Philippe Guerin, director of the Worldwide Antimalarial

Resistance Network (WWARN), says the study "highlights that the pace at which

artemisinin resistance is spreading or emerging is alarming." He adds:

"We need a more vigorous international effort to address this issue

in border regions."

Meanwhile, Medical News Today recently learned how scientists are

developing a geographical information system (GIS) to fight parasitic diseases like

malaria using satellite data combined with health

data. The idea is that decision makers can use the GIS to quickly locate the high-risk areas and see if they have enough resources there.

Written by Catharine Paddock PhD

Courtesy: Medical News Today Note: Any medical information available in this news section is not intended as a substitute for informed medical advice and you should not take any action before consulting with a health care professional.