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Malaria is a mosquito-borne disease that kills over 600,000 people each year, predominantly children in sub-Saharan Africa. Though a significant amount of resources have been put toward addressing this problem and saving lives, a strain of the disease that is resistant to artemisinin—the frontline medication used in malaria treatment—could pose an incredible new challenge. A new paper published in The Lancet describes the presence of this resistant form of malaria in Myanmar. If this disease pushes through Asia into Africa, countless lives will be put at risk. 

"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," senior author Charles Woodrow of Oxford University said in a press release. "With artemisinins 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.”

The data was obtained from 940 samples from malaria patients at 55 health centers across Myanmar. Genetic sequencing of the malaria-inducing parasite Plasmodium falciparum sought to identify mutations in the K13 gene that are associated with a resistance to artemisinin. Astonishingly, 39% of the samples were shown to have that drug resistance.

"We were able to gather patient samples rapidly across Myanmar, sometimes using discarded malaria blood diagnostic tests and then test these immediately for the K13 marker, and so generate real-time information on the spread of resistance" added corresponding author Mallika Imwong from Mahidol University in Bangkok.

Moving forward, the researchers will try to use this data to predict where this form of malaria will appear next. Unfortunately, the greatest rate of incidence is in the northwestern corner, where it may have easy access to cross into India. If that occurs, it could make it all the way into Africa, threatening millions of lives along the way. Researchers and health care officials will need to be very proactive in trying to minimize the spread of disease. 

"The identification of the K13 markers of resistance has transformed our ability to monitor the spread and emergence of artemisinin resistance," co-author Philippe Guerin from the Worldwide Antimalarial Resistance Network (WWARN) explained. "However, this study highlights that the pace at which artemisinin resistance is spreading or emerging is alarming. We need a more vigorous international effort to address this issue in border regions.”

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