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‘Super malaria’ sweeps South East Asia

Published on 25/09/17 at 09:55am

There has long been concern over cases of drug-resistant malaria emerging in Asia and now it has been revealed that a particular strain of ‘super malaria’ has spread from Cambodia to Vietnam. The strain of malaria has developed to be resistant to both artemisinin and its partner treatment, piperaquine.

The incidence within Cambodia of the malaria is particularly high, with treatment alleged to be failing as often as 60% of the time. The spread to the south of Vietnam has caused concern that the multidrug resistant malaria may well spread further within Asia and potentially crossover to higher risk areas, such as India and, of more concern, Africa.

A recent letter to The Lancet, contained the following warning from researchers: “Artemisinin resistance is associated with mutations in the PfKelchgene. Initially multiple independent Kelch mutations were observed, but in a recent sinister development, a single dominant artemisinin-resistant P falciparum C580Y mutant lineage has arisen in western Cambodia, outcompeted the other resistant malaria parasites, and subsequently acquired resistance to piperaquine.”

The letter later goes onto state that the rise in cases are of “international concern”.

There are an estimated 214 million cases of malaria worldwide, which result in approximately 438,000 deaths. It is judged that 90% of these deaths occur in Africa and has experts worried that should this type of malaria manage to spread to the continent, it could have a devastating impact.

Already there is a 30% failure rate of the combination treatment in Vietnam, and the malaria has also spread into neighbouring Laos.

Co-author Professor Sir Nicholas White, of Mahidol and Oxford universities, said: "We are losing a dangerous race. The spread of this malaria 'superbug' has caused an alarming rise in treatment failures, forcing changes in drug policy and leaving few options for the future."

The development of this treatment-resistant malaria is just part of a wider global trend towards ‘superbugs’ that are no longer manageable with current therapies. Around 700,000 people die per year as a result of drug-resistant infections.

Ben Hargreaves

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