According to a study, early diagnosis and treatment with antimalarial drugs (ACTs—artemisinin based combination treatments) has been linked to a reduction in malaria in the migrant population living on the Thai-Myanmar border, despite evidence of increasing resistance to ACTs in this location. The study that was conducted by international researchers was published in this week's PLOS Medicine.
These findings are important as this study suggests that alternative treatments are urgently needed to replace the failing first line drug regimen (mefloquine and artesunate).
The authors, led by François Nosten from the Shoklo Malaria Research Unit in Thailand, reached these conclusions by analysing information collected between October 1999 and September 2011 in this region.
The authors also found that the ratio of P. falciparum to P. vivax (a less severe form of malaria) ratio fell from 1.4 to 0.7 and the rate of P. falciparum decreased from 24.3% to 3.4%.
However, worryingly, in the small number of patients undertaking drug resistance tests, the authors found that the effectiveness of ACTs fell steadily with the proportion of patients on treatment but still infected with malaria at day 3, increasing from 0% in 2000 to 28% in 2011.
The authors say: "Despite the emergence of resistance to [ACT] in P. falciparum, the strategy of early diagnosis and treatment with ACT has been associated with a reduction in malaria in the migrant population living on the Thai-Myanmar border."
They continue: "Eliminating P. falciparum or dramatically reducing the number of cases is feasible, but the main obstacle is the difficulty of accessing populations living in remote, sometimes dangerous areas and across international borders."
The authors conclude: "Alternative fixed combination treatments are needed urgently to replace the failing first-line regimen of mefloquine and artesunate."