What is going on with the’magic’ drug?
The Role of Partial Resistance to Artemisinin in Malaria Control: A Study on Southeast Asia by Namazzi and Jordan Haldar
Rosenthal is still worried about this news. “The emergence of artemisinin partial resistance in Africa is a major threat to malaria control,” he says. “We are now only starting to understand what’s going on.”
After an infected mosquito bites you and deposits the malaria parasite into your body, the parasite starts to replicate. That’s where artemisinin comes in. Given intravenously at regular intervals, it can kill most of the parasites in a patient’s blood within hours. Patients who use the drug for several days can be seen by Namazzi.
She says the situation in Southeast Asia is different because they don’t have as much malaria as African countries, and researchers understand their parasites better.
Finally, on top of all this, the researchers found signs of resistance to an oral antimalarial drug kids are often sent home with: artemether lumefantrine. The drug is supposed to remove parasites from the body. But about 10% of the patients that doctors thought were better showed up sick again, within a month.
Some of the children were found to have a malaria parasites that had altered genes and this is linked to resistance to the antibiotics used to treat it.
“These are very critically ill children,” she says, explaining that children are at greater risk of severe malaria than adults because they have not yet gained immunity. A severe case of malaria in a child can cause a number of problems, such as high fever, convulsions and even death. “A child can become extremely weak. They can’t rely on themselves to feed themselves.
As the study authors pored over the findings, three things concerned them: First, they found that for 11 of the 100 children it took longer than normal — more than 5 hours — for artemisinin to kill at least half the parasites in the bloodstream. The World Health Organization considers these kids to have partial drug resistance. (It’s not complete resistance because the kids did eventually get better.) “Think about it, for any infection, more than 10 out of 100 people you treat don’t get better [quickly]. Haldar said that it’s really pretty bad.
Between treating patients, she says, they voice their concerns: “‘Malaria’s very stubborn,'” she says they tell her. It is not responding to treatment.
The Makerere University College of Health Sciences lecturer has been taking artemisinin for a long time. Millions of lives have been saved by a Chinese malaria treatment that was rediscovered several decades ago. The person who helped revive the medical recipe received a prize for her work.
“It works like magic,” says Namazzi. The parasite clearance was very fast. It had fewer things to deal with. The mortality was lower.
She wanted to know what was happening. She joined with other people to figure it out. They had several hypotheses: Maybe the dose is too small or perhaps the patients aren’t completing the full medication course.
Children with malaria in Uganda: monitoring their diet and blood parasites, and monitoring their blood paramagnetic infection through a novel malaria-prevention strategy
Researchers studied 100 children with severe malaria in Uganda over a two-year period, closely monitoring their intake and regularly evaluating their blood parasites.
A study found that for 11 of the 100 children with severe malaria in Uganda, it took longer than normal to kill at least half the parasites in the bloodstream. The World Health Organization (WHO) considers these kids to have partial drug resistance (it’s not complete resistance because the kids did eventually get better).