Two recent studies of malaria along the Thailand-Burma border show that drug-resistant malaria in the region is increasing at an alarming rate, with one study showing a 3,335 percent increase in the last 10 years.
The reports, Emergence of artemisinin-resistant malaria on the western border of Thailand: a longitudinal study published in The Lancet and A Major Genome Region Underlying Artemisinin Resistance in Malaria, published in the journal Science, show drug-resistant malaria is rapidly moving into new areas
Funded by the Wellcome Trust and the US National Institutes of Health, the two research projects included scientists from Bangkok’s Mahidol University, the Centre for Tropical Medicine at Britain’s Oxford University, and the Texas Biomedical Research Institute in the USA, found that 42 percent of malaria cases in western Cambodia were resistant to drug treatment, indicating that drug resistant malaria along the Thailand-Burma border is rapidly approaching the rate in Cambodia.
Researchers said malaria that was resistant to the current standard drug therapy, artemisinin, had spread more than 800km (500 miles) west to the Thailand-Burma border since it was confirmed in Cambodia in 2006, with a study of 3,202 people who contracted malaria in the region between 2001 and 2010 finding a steady increase in the time it took for the disease to be eliminated from their body ‚Äì from 0.6 percent of cases in 2007 to 20 percent in 2010.
According to The Lancet, the speed with which drug-resistant malaria is growing along the Thailand-Burma border means drug-resistant malaria will reach rates equivalent to those reported in western Cambodia in between two to six years.
Of concern is a finding in the report published in Science, where researchers identified a region of the Plasmodium falciparum (P. falciparum) parasite’s genome that may be mutating in order to survive.
The study compared the genomes of 91 P. falciparum parasites from Cambodia and western Thailand with those from Laos, where drug resistant malaria has so far not emerged, and found seven genes that may be responsible for the parasites resistance to malaria treatment drugs, and which may explain the up to 35 percent malaria drug resistance that is occurring in Southeast Asia.
Thailand-Burma border malaria resistant to our best drugs
Leader of the study, Francois Nosten, director of the Shoklo Malaria Research Unit who studies and treats malaria in the Thailand-Burma border region said, “we have now seen the emergence of malaria resistant to our best drugs, and these resistant parasites are not confined to western Cambodia”.
Mr Nosten said, this is very worrying and suggests we are in a race against time to control malaria in this region before P. falciparum drug resistance worsens, develops, and spreads further.
Though the number of deaths in Africa from malaria have been decreasing in recent years due to increased artemisinin drug use and wider distribution of insecticide-treated bed nets, the World Health Organization (WHO) says an estimated 655,000 people died from the disease in 2010, though a 2010 report by the Institute of Health Metrics and Evaluation at the University of Washington, Seattle put the figure at up to 1.2 million people.
If resistance to artemisinin drug regimes continues to spread some specialists fear Africa could see a resurgence in drug-resistant malaria and a reversal of the inroads made in combating the debilitating and deadly disease.
While residents of malaria endemic areas are well educated in the risk, precautions and symptoms, this does not apply equally so travelers and the UKs Health Protection Agency (HPA) reported last year an almost 30 percent increase in the number of Britons contracting malaria in 2009 and 2010.
Rapid malaria tests for travelers
According to the HPA report, of the 1,761 confirmed cases in 2010 and 1,495 cases reported in 2009, almost 40 percent of Britons who contracted malaria had visited Nigeria or Ghana, while 11 percent had been to India.
Home Kit Biotech (HKB) is an internet-based business that sells a range of instant blood screening instant test kits, including rapid instant test kits for malaria and dengue fever.
Pam Johnson, HKB customer service manager, said there was a steady demand for the company’s rapid medical test kits for travelers, which comprises a rapid Malaria instant test kit and a rapid Dengue instant test kit.
“People are increasingly traveling to and spending longer periods of of time in malaria infected areas for work, as tourists, or volunteers and often there are language problems or the nearest reliable medical testing facility is hundreds of kilometers or more away .
“Our rapid medical test kits for travelers are proven to be able to detect 99.6 percent of all positive cases (sensitivity) and 99.7% accurate at returning false positives (specificity), which means for less than $26 (¬£19.85) people can test them self and provided they follow the instructions, receive a pretty accurate diagnosis of whether they are infected with malaria or not”.
Ms Johnson said that HKB will soon be adding a rapid chikungunya instant test to it’s rapid medical test kits for travelers, with increasing reports of outbreaks in Cambodia, China and India in particular.
¬© 2012 John Le Fevre
Drug resistant malaria, Thailand-Burma border, malaria instant test kits, dengue instant test kit, rapid medical test kits for travelers, female¬†Anopheles albimanus mosquito, Mahidol University, Francois Nosten, Shoklo Malaria Research Unit, artemisinin, malaria, medical research, Medical science, Mahidol University, World Health Organisation
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