Malaria parasite can now resist main line of treatment: Uganda study

Researchers flag risk of cross-border spread of malaria, especially in east Africa   

By Madhumita Paul
Published: Monday 27 September 2021

The parasite causing malaria has developed resistance to the primary drug used to treat the disease, a new study in Uganda claimed

Artemisinin and artemisinin-based combination therapies are the most effective and widely used treatment for malaria. Plasmodium falciparum, the parasite causing the disease, showed genetic mutations in nearly 20 per cent blood samples studied between 2015 and 2019, the study found.

The study was conducted from 2015 through 2019 at St Mary’s Hospital Lacor in Gulu, northern Uganda, where malaria transmission is high. 

The findings, published in the New England Journal of Medicine September 23, 2021, suggested that the main drug losing effectiveness against malaria could potentially lead to cross-border spread of the disease. 

Nicholas White, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand, wrote in an accompanying editorial in the journal:  

Health officials in East Africa should begin looking at strategies to contain artemisinin resistance, such as including additional partner drugs or using two different ACTs to treat malaria patients.

The findings are concerning because reduced susceptibility to the artemisinin component of ACT puts greater pressure on the partner drug, he added.

Resistant forms of malaria were previously detected in Asia. But experts fear it could have a devastating impact in Africa, which accounts for more than 90 per cent of the world’s malaria cases. 

Some isolated drug-resistant strains of malaria were previously isolated in Rwanda.

The researchers examined 240 blood samples during the study period. For 14 participants who were given the artemisinin therapy, it took longer than five hours to clear half the malaria-causing parasites.

It should take a couple of hours after intravenous administration of artesunate, a potent derivative of artemisinin, to clear this parasite load, according to World Health Organization (WHO).

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