fears of resistance of malaria to treatment are growing

Fears that malaria will become resistant to treatment in Africa are reinforced by the first “Clinical evidence” of the impact of mutations in the parasite responsible for the disease, provided Thursday, April 14 by researchers. Their study, carried out on children in Rwanda, finds for the first time that these mutations are accompanied by a persistence of the parasite after three days of treatment (called “delayed parasite elimination”), as had been demonstrated for the first time. times in Southeast Asia when resistance to the main drug, artemisinin, began to emerge.

The effectiveness of the drugs remains high so far, but increased surveillance in Rwanda and neighboring countries is needed, warns the study, published in The Lancet Infectious Diseases. Malaria killed more than 400,000 people worldwide in 2019, including two thirds of children under the age of five. The overwhelming majority of cases (94% of the 229 million worldwide) and deaths occur in Africa, according to the WHO. Artemisinin-based treatments, combined with another antimalarial (CTA / ACT), introduced in the early 2000s, are currently the most effective and the most widely used against malaria, caused by a parasite (Plasmodium falciparum) transmitted by mosquitoes.

Warning signal

This drug resistance is associated with parasites carrying mutations of a gene (pfk13). Some mutations had already been detected in Rwanda, but at a lower frequency than in the new study, and without demonstrated persistence of the parasite in children treated with artemisinin. Artemisinin resistance was first identified in Cambodia in 2008. In the Mekong region, once artemisinin resistance became widespread, resistance to the associated drug often followed, leading to failure. combination therapy (CTA). “The emergence of partial resistance to artemisinin in Africa is a warning signal that the efficacy of ACTs could be compromised if resistance to its associated drug emerges”, note the researchers.

The study involved 224 children from six months to five years old infested by the parasite, in three towns in Rwanda: they were treated for three days with the most common therapeutic combination (artemether-lumefantrine) then monitored for one month. with weekly blood samples. Of the participants, about 15% at two study sites still had detectable parasites three days after treatment. “Recent data suggests that we are on the verge of clinically significant artemisinin resistance in Africa, as happened in South East Asia over ten years ago.”, alarmed in the newspaper Professor Philip Rosenthal (University of California, San Francisco), who did not participate in the study.

– .

Leave a Reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.

Recent News

Editor's Pick