Friday, 20 February 2015

#MalariaResistance #K13MolecularMarker #GlobalMalariaProgramme #ArtemesininResistance


A recent study published in The Lancet infectious diseases, has recorded high prevalence of P falciparum parasites carrying K13-propeller mutations next to the northwestern border of Myanmar with India. The study was a cross-sectional survey between Jan 2013-Sep 2014 at 55 malaria treatment centres in Myanmar, and in relevant border regions in Thailand and Bangladesh.

The main results observed are:
  •            39% of samples with K13-propeller mutation
  •           70% of the ten administrative regions of Myanmar, the combined K13-mutation prevalence was more than 20%
  •           Geospatial mapping showed an overall prevalence of K13 mutations exceeding 10% in much of the east and north of the country
  •           In Homalin, Sagaing Region, 25 km from the Indian border, 21 (47%) of 45 parasite samples carried K13-propeller mutations.
  •           Artemisinin resistance extends across much of Myanmar.


Some of the factors leading to the development of artemisinin resistance are:
·        Uncontrolled use of artemisinin-based combination therapy (ACT)
·        Mobile populations and migrants
·        Artemisinin monotherapy
·        Use of subtherapeutic levels of artesiminin
·        Substandard and counterfeit drugs
·        High treatment cost, and
·        Co-use of artemisinin derivates as prophylactic agents

Way forward
According to the #GlobalMalariaProgramme by WHO the continued use of oral artemisinin-based monotherapy (oAMT) is one of the main contributing factors for the development and spread of artemisinin resistance. The way forward is to protect the therapeutic life of artemisinin-based combination therapy (ACT).
In view of the rapidly spreading artemisinin resistance, the countries specially affected will be malaria-endemic countries. This will also threaten the progress achieved in malaria control by many countries.  

Read more at
http://www.thelancet.com/journals/laninf/article/PIIS1473-3099(15)70032-0/abstract
http://www.who.int/malaria/publications/atoz/oral-artemisinin-based-monotherapies-1may2014.pdf

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