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Submitted by ruzik_tuzik on Aug 11th, 2009
Malaria parasites in western Cambodia have become resistant to artemisinin-based therapies, the first-line treatment for malaria. Resistance to the drugs makes them less effective and could eventually render them obsolete, putting millions of lives at risk.
Signs of artemisinin resistance have been reported in the region already, but this new research is the first detailed study of the problem. The study was funded by the Wellcome Trust, the Li Ka Shing Foundation, and the Global Malaria Programme of the World Health Organisation.
The most effective anti-malaria drug is artemisinin. The artemisinin derivatives have the advantage over other anti-malaria drugs, such as chloroquine and mefloquine, in having few side effects and until now malaria parasites have shown no resistance against it.
The researchers studied forty patients in each of Pailin, western Cambodia, and Wang Pha, north-western Thailand. In two open-label, randomised trials, each was given the relevant dosage appropriate to their body weight of either artesunate or a combination of artesunate and mefloquine. On average, patients in Thailand were clear of parasites in 48 hours; in western Cambodia this took 84 hours - almost twice as long.
During the treatment period, as the number of parasites in the blood falls, the infection should clear. Its recurrence can be a sign that the drug treatment is not working effectively. Artemisinin-based drugs have been in use in western Cambodia for around thirty years and the country was one of the earliest to switch to ACTs in 2001.
However, the majority of patients in the region receive their medication from the private sector, which is less well regulated. Patients in the private sector are frequently provided with monotherapies or incomplete treatment courses. Added to this is the problem of substandard or counterfeit drugs with sub-clinical doses of artemisinin. This extended period of sub-optimal use of artemisinin-based drugs may have contributed to the emergence of resistance.
Source: Public Health Agency of Canada
Submitted by ruzik_tuzik on Aug 11th, 2009
Malaria parasites in western Cambodia have become resistant to artemisinin-based therapies, the first-line treatment for malaria. Resistance to the drugs makes them less effective and could eventually render them obsolete, putting millions of lives at risk.
Signs of artemisinin resistance have been reported in the region already, but this new research is the first detailed study of the problem. The study was funded by the Wellcome Trust, the Li Ka Shing Foundation, and the Global Malaria Programme of the World Health Organisation.
The most effective anti-malaria drug is artemisinin. The artemisinin derivatives have the advantage over other anti-malaria drugs, such as chloroquine and mefloquine, in having few side effects and until now malaria parasites have shown no resistance against it.
The researchers studied forty patients in each of Pailin, western Cambodia, and Wang Pha, north-western Thailand. In two open-label, randomised trials, each was given the relevant dosage appropriate to their body weight of either artesunate or a combination of artesunate and mefloquine. On average, patients in Thailand were clear of parasites in 48 hours; in western Cambodia this took 84 hours - almost twice as long.
During the treatment period, as the number of parasites in the blood falls, the infection should clear. Its recurrence can be a sign that the drug treatment is not working effectively. Artemisinin-based drugs have been in use in western Cambodia for around thirty years and the country was one of the earliest to switch to ACTs in 2001.
However, the majority of patients in the region receive their medication from the private sector, which is less well regulated. Patients in the private sector are frequently provided with monotherapies or incomplete treatment courses. Added to this is the problem of substandard or counterfeit drugs with sub-clinical doses of artemisinin. This extended period of sub-optimal use of artemisinin-based drugs may have contributed to the emergence of resistance.
Source: Public Health Agency of Canada
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