Beyond superbugs: Drug companies have now managed to create drug-resistant MALARIA, too

Wednesday, February 24, 2016 by: David Gutierrez, staff writer
Tags: drug-resistance, malaria, superbugs

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(NaturalNews) Just as global malaria rates are beginning to fall, a new development has emerged that threatens to undo all the progress made in containing the disease. According to a study published in the journal The Lancet Infectious Diseases, the presence of multi drug-resistant malaria has been confirmed in at least three separate provinces of Cambodia.

Scientists had suspected multi drug-resistant malaria for several years, but it had never before been confirmed in a laboratory.

"The risks are significant," said Robert Newman, director of the WHO's Global Malaria Program, in 2013. "Not only are they significant for the region in terms of having a reversal of the gains that have been made against malaria, but they are actually significant globally."

"If history is any guide, if we were not to contain this problem then it is very likely to spread elsewhere," he said. "Especially risky is to sub-Saharan Africa, where the greatest burden still exists. And, if we were to lose the efficacy of the [frontline treatments] ... today, this really would be a public health catastrophe in Africa."

Drug resistance builds on itself

Researchers have known for years that resistance to the malaria drug artemisinin – formerly the most effective and fast-acting malaria treatment – was spreading. This led to the adoption of cocktails of artemisinin with other anti-malaria medications – known as artemisinin combination therapy (ACT) – as the frontline malaria treatment in places that have widespread artemisinin resistance (mainly Southeast Asia).

One of the most popular ACTs is dihydroartemisinin-piperaquine, which uses piperaquine as the partner drug. This has been Cambodia's frontline malaria treatment since 2008, and is one of the few drugs effective against many Cambodian malaria strains.

"The intensive spread of artemisinin resistance in Cambodia is rapidly threatening to reduce the efficacy of all artemisinin combination therapies used in this country and in bordering areas of Vietnam, Laos, and Thailand," the researchers wrote.

For the new study, researchers treated 204 malaria patients, aged 2 to 65, in three Cambodian provinces. All participants had been diagnosed with strains at least partially resistant to artemisinin.

The blood of every participant was almost immediately cleared of parasites upon treatment with
dihydroartemisinin-piperaquine. After 63 days, however, parasites had reemerged in 1.67 percent of participants in Ratanakiri province, 15.9 percent in Preah Vihear and 45.7 percent in Pursat. The rates of resurgence were highest in places that also had the highest rates of artemisinin resistance.

Laboratory tests confirmed that the malaria parasites in the blood of patients who suffered resurgence were in fact resistant to piperaquine. They were more susceptible, however, to the drug mefloquine. This led the researchers to suggest introducing a cocktail of artesunate (a close relative of artemisinin) and mefloquine as the new first-line treatment in these areas.

Evolving too fast to be contained

The researchers blamed the spread of piperaquine resistance on over-prescription of dihydroartemisinin-piperaquine by private drug brokers catering to people who want to treat their malaria without visiting a doctor.

"Intensified efforts are needed to discourage what appears to be a highly ineffective approach of self-treatment in the private sector," they wrote.

The researchers warned that if the multi drug-resistant strain spreads, it could wreak global devastation. That's what occurred in the 1950s, after chloroquine-resistant malaria emerged in Cambodia and spread worldwide.

"Because few other artemisinin combination therapies are available, and because artemisinin resistance will probably accelerate resistance to any partner drug, investigations of alternative treatment approaches are urgently needed," the researchers said.

Unfortunately, drug-resistant strains may be evolving so fast that containment may only slow their spread. In 2013, the World Health Organization (WHO) noted that an effort to prevent artemisinin-resistant malaria from spreading in Cambodia appeared to be working, but that artemisinin-resistance had then independently arisen in Thailand, Burma and Vietnam.

That same year, the agency announced a three-year, $400-million effort to eradicate multi drug-resistant malaria in southeast Asia. The new study suggests that that effort is failing dramatically.

Sources for this article include:

Trust.org

ScienceDaily.com

Malaria.com