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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