- Researchers found malaria superbugs that are resistant to drugs.
- They were
identified in Cambodia, Laos and Thailand and threaten to spread through
India to Africa.
- These superbugs
were fitter and more
infectious than previous strains of the malarial parasite
resistant strains of P. falciparum
termed malaria superbugs, were recently identified in certain regions in Laos,
Thailand and Cambodia. These superbugs have led to failure in treatment rates
when treated with malaria
medicines against falciparum
combination therapies (ACTs). The study published in
the journal The Lancet Infectious
details the P.falciparum
lineage that threaten to spread globally, affecting eradication efforts.
has been an increase in the multi-drug resistant strains of P.falciparum
which the authors of the
study warn about
- In Cambodia,
there is wide spread presence of malaria parasites which are resistant to
both piperaquine and artemisinin
- In Northeastern
Thailand, Western Cambodia and Southern Laos, there are more virulent
multidrug resistant parasites.
Head of Malaria and Deputy Head of the Mahidol Oxford Tropical Medicine
Research Unit (MORU) Prof. Arjen Dondorp who is also the lead author of the
study said that the scientists were able to identify the emergence of a highly
successful multi-drug lineage of the parasite, which was far superior to the
other strains and which was now spreading to other areas. The lead author
stated that these malarial parasite strains were resistant to even the partner
drug piperaquine, resulting in increased failure of treatment with artemisinin
combination therapy Dihydroartemisinin-piperaquine.
study was conducted, according to the authors, to re-emphasize the growing
trend of resistant strains of malaria and the urgent need to lower their
numbers, before malaria becomes untreatable in Asia.
Spread of Resistant
Malaria Strain Through India
scientists involved in the study state that consequent spread of the multi-drug
resistant strain of malaria parasite via India to the regions of sub-Saharan
Africa could result in a global epidemic, leading to catastrophic effects.
There has been a warning provided by the study authors to increase monitoring
in the Greater Mekong Sub-region with increased efforts to prevent spread to neighboring regions.
‘Drug Resistant Strains of Plasmodium could Increase severity and spread of malaria’
Sir Nicholas White said that the race to eliminate artemisinin resistant
malaria is already a losing battle as the resistance to associated
anti-malarial drugs has already begun setting in. He further stated that "The
consequences of resistance spreading further into India and Africa could be
grave if drug resistance is not tackled from a global public health emergency
scientists analyzed blood samples of patients who were suffering from
malaria and who were infected in Myanmar, Laos,
Thailand and Cambodia. The findings of the study were
- The single mutant
parasite strain PfKelch13 C580Y had spread across three countries.
- It resulted in
replacement of strains that were found to be less resistant to artemisinin
- The strains with
the C580Y mutation is not more resistant to artemisinin but is found to be
fitter, implying that is transmitted more often and spreads fast.
PfKelch13 C580Y strain
Sir Nicholas White said that the C580Y mutation in P.falciparum was not
responsible for the malaria parasite being fitter but other genetic alterations
could aid in it being fitter. This has resulted in the evolution of a new
lineage of super bugs that are more transmissible and fitter. The senior author
stated that the spread of malaria via India and Africa has occured before and the result was the death of millions of people due to
the disease. With the spread of drug resistance strains and the lack of
effective therapy, it could again be very drastic. There is a concerted effort
needed in building collaborative strategies that address the threat in Asia in
urgency to prevent a repeat of the earlier epidemic.
Head of Infection and Immunobiology at Wellcome Trust, Dr. Mike Turner said
that there were many hundred who lost their lives every year due to infectious
and drug resistant strains, which include malaria. This number could increase
to millions by 2050 if corrective measures are not taken.
monitoring of the spread of the disease and improvements in care are necessary
is a cause of public health concern across many regions in the world with
transmission occurring regularly. It is a complex disease and varies in
intensity based on epidemiology. The most susceptible population are pregnant
women, small children, tourists to malaria prone areas who have not been
immunized as they could develop fatal illness.
time taken for the symptoms to start is between 7 to 18 days, based on the
parasite that causes the infection. In very rare cases, it could take up to a
year for the symptoms to show. The initial symptoms are high fever, headache,
chills and vomiting. These symptoms could be mild and it may make it difficult
to distinguish it as malaria.
in certain types of malaria there is a 48 hour fever cycle when there is cold
and shivering. There is a period of shivering with the individual feeling cold,
followed by high fever and then again sweating and fatigue. The person may also
have muscle pain
general feeling of tiredness and diarrhea
is a very severe form of malaria which is caused by the parasite P.falciarum
and without immediate
treatment; this infection could become life threatening with difficulty in
breathing and organ failure.
development of drug resistance has resulted in the spread of the disease to
newer regions and also in the re-emergence of the disease in areas where the
disease has been eradicated. The severity of the disease and the occurrence of
the disease have also been affected due to drug resistance while travel or
population movement has resulted in the transfer of these drug resistant malaria strains
There is a highly important need to develop strategies to prevent the
spread of these strains of malaria as it could lead to a disease of epidemic
- Drug resistance in malaria - (http://www.who.int/csr/resources/publications/drugresist/malaria.pdf)
- Malaria - Symptoms - (http://www.nhs.uk/Conditions/Malaria/Pages/Symptoms.aspx)