Resistant Malaria: The Global Threat is Spreading

Researchers have determined that antibiotic-resistant malaria is spreading once again, making its way from the little-known country of Myanmar to India. This has experts panicking, because if this strain of resistance travels from Asia into mosquito populations on the African sub-continent, millions of lives could be at risk.

The big concern here revolves around the drug artemisinin, the frontline treatment - and often only treatment - against malaria infection in undeveloped worlds.

A report recently published in the journal Lancet Infectious Diseases details how the Mahidol-Oxford Tropical Medicine Research Unit (MORU) in Bangkok, Thailand recently coordinated a new field survey of mosquito populations and malaria patients in Myanmar, as well as its bordering region, to measure the prevalence of artemisinin-resistant Plasmodium falciparum - the tiny single-celled protozoan that causes malaria.

The researchers examined whether parasite samples collected at 55 malaria treatment centers carried key mutations for this dangerous resistance. Unfortunately, they did identify numerous resistant parasites in Homalin, Sagaing Region, located only 15 miles from the boarder of India.

Specifically, the DNA sequencing of the P. falciparum parasites (collected between 2012 and 2014) revealed that 371 (~ 39 percent) carried a resistance-conferring mutation. If these parasites were to find their way into a human host, and from there into local mosquitoes, an unaffected region could quickly have a drug-resistant epidemic of malaria on its hands.

"Myanmar is considered the frontline in the battle against artemisinin resistance as it forms a gateway for resistance to spread to the rest of the world," Charles Woodrow, the senior author of the report, explained in a statement.

He added that thanks to the vigilance of work like this, however, "we are in the unusual position of having molecular markers for resistance before resistance has spread globally. The more we understand about the current situation in the border regions, the better prepared we are to adapt and implement strategies to overcome the spread of further drug resistance."

"However, this study highlights that the pace at which artemisinin resistance is spreading or emerging is alarming," said Philippe Guerin, Director of the Worldwide Antimalarial Resistance Network (WWARN) and co-author of the study. "We need a more vigorous international effort to address this issue in border regions."

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