Drug-resistant malaria could spread fast, expert warns

[Gert van der Hoek]

nov 18 2010


Malaria drug resistance spreading in Cambodia

The World Health Organisation is warning that resistance to the malaria drug artemisinin appears to be spreading out from the Cambodia-Thailand border, where it was first detected.

The WHO says resistance to the drug may also be emerging on the Burma-Thailand border.

The international health body says it is concerned that resistance could spread as far as Africa, as was the case with anti-malaria drugs in the 1960s and 1970s.

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Published 18 November 2010

Better surveillance is needed to halt spread of artemisinin resistant malaria

Countries where malaria is endemic need to improve monitoring of the effectiveness of drugs to prevent a ?dramatic? rise in the cost of the treating the disease, warns the World Health Organization.

?Without regular monitoring and reporting of antimalarial drug resistance, the disease burden and the economic costs of malaria will rise dramatically,? says the agency in a report of its global review of drug effectiveness and resistance over the past decade.

The call comes after the confirmation in February 2009 of the emergence of resistance of Plasmodium falciparum to artemisinin in the Cambodia-Thailand border region.

BMJ

 

[Gert van der Hoek]

Re: Malaria drug resistance spreading in Cambodia - WHO

Re: Malaria drug resistance spreading in Cambodia - WHO

WHO calls on malaria-endemic countries to strengthen monitoring of antimalarial drug efficacy

National monitoring essential step in preventing the emergence of malaria drug resistance

18 NOVEMBER 2010 | GENEVA -- WHO is calling on countries to be increasingly vigilant in monitoring antimalarial drug efficacy in order to allow for early detection of artemisinin resistance.1 This is one among several conclusions of the Global report on antimalarial drug efficacy and drug resistance: 2000?2010, released today. The report is based on 1100 studies conducted by national malaria control programs and research institutes over the ten-year period.

The report estimates that only 34% of malaria-endemic countries are complying with WHO recommendations to routinely monitor the efficacy of first- and second-line antimalarial medicines.2

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Resistance to artemisinin

In February 2009, WHO confirmed that resistance to artemisinin had emerged on the Cambodia-Thailand border. Although patients infected were cured following treatment with an artemisinin-based combination therapy (ACT), the recovery took more time. In artemisinin-resistant areas, the high cure rates observed depend heavily on the efficacy of the non-artemisinin component of the combination.

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Containing the spread of artemisinin resistance

Efforts to contain the spread of artemisinin resistance on the Cambodia-Thailand border have been ongoing since November 2008. However, there is some early evidence that resistance to artemisinins may also be emerging on the Myanmar-Thailand border. There is also concern that resistance could spread from the Cambodia-Thailand border to Africa, as it did with antimalarial drugs such as chloroquine and sulfadoxine-pyrimethamine in the 1960s and 1970s.

Read more - WHO Press Release

 

[Gert van der Hoek]

Re: WHO - Better surveillance is needed to halt spread of artemisinin resistant malaria

Re: WHO - Better surveillance is needed to halt spread of artemisinin resistant malaria

Drug-resistant malaria could spread fast, expert warns

(Reuters) - Drug-resistant malaria could spread from southeast Asia to Africa within months, putting millions of children's lives at risk, a leading expert warned on Wednesday.

Nicholas White, professor of tropical medicine at Mahidol University in Bangkok, called for a war before it is too late on the malaria strain resistant to the drug artemisinin that first emerged along the Thai-Cambodian border in 2007.

This longer-to-treat form of malaria is suspected of breaking out along the Thai-Myanmar frontier and in a province of Vietnam, where tests are under way to confirm it, but the great fear is of it reaching Africa.

"It is a time bomb, it is ticking. It has the potential of killing millions of African children," White told Reuters.

A migrant worker who doesn't even show symptoms could spread the resistant parasite beyond Asia, he said. "It could be a Chinese worker acting as an adviser in Cambodian forests who then hops on a plane to Africa. It could go off at any minute."

Earlier, the World Health Organization (WHO) launched a $175 million annual plan to contain and prevent the global spread of the artemisinin-resistant parasite beyond the Mekong region.


read more

 

[Gert van der Hoek]

Re: Drug-resistant malaria could spread fast, expert warns

Drug-Resistant Malaria Vexes Health Workers in Cambodia

August 24, 2012

PHNOM PENH ? A little-known battle being fought in Cambodia could have global ramifications. The fight is against drug-resistant malaria.

The problem is more severe in Cambodia than anywhere else in the world, says Steven Bjorge, the World Health Organization's malaria team leader in Cambodia.

About 17 percent of all cases in the Cambodian-Thai border area of Pailin were drug-resistant in 2011, up from 10 percent the year before, according to Char Meng Chuor, director of the government?s National Malaria Center. He says the drug-resistant disease has also spread to parts of Preah Vihear and Pursat, border provinces in Cambodia?s north and west.

Drug-resistant malaria first evolved in Cambodia in the 1950s and 1960s, according to Bjorge.

?Since then, every new drug seems to first become resistant in Cambodia or on the Thai-Cambodian border before anywhere else in the world,? he said.

Drug resistance occurs when a patient infected with the Plasmodium falciparum parasite takes an incomplete or incorrect course of anti-malarial drugs. This allows the parasite to evolve resistance to that medicine, so patients must take another course of drugs under the supervision of a doctor, says Char Meng Chuor.

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In a normal case of malaria, a course of drug treatment can eliminate the parasite from the patient?s blood within three days. But in drug-resistant cases, this is not enough to clear the parasite. With these patients, it can take anywhere from five to 28 days to flush out the malaria parasite.

In Cambodia, the overall number of cases of malaria continues to drop, and with proper control, even the numbers of drug-resistant cases should fall, says Bjorge of the WHO.

More: VOA