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Africa Malaria

Malaria in Africa: Parasite ‘resistant to artemisinin’ – BBC News

Mosquitoes

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The malaria parasite is spread by the bite of infected mosquitoes

A drug-resistant strain of the parasite that causes malaria has been identified by scientists in Rwanda.

The study, published in Nature, found the parasites were able to resist treatment by artemisinin – a frontline drug in the fight against the disease.

This is the first time scientists have observed the resistance to the drug artemisinin in Africa.

The researchers warns that this “would pose a major public health threat” in the continent.

Scientists from the Institut Pasteur, in collaboration with the National Malaria Control Program in Rwanda (Rwanda Biomedical Center), the World Health Organization (WHO), Cochin Hospital and Columbia University (New York, USA) analysed blood samples from patients in Rwanda.

They found one particular mutation of the parasite, resistant to artemisinin, in 19 of 257 – or 7.4% – of patients at one of the health centres they monitored.

Evolution of parasites

In the journal article the scientists warned that malaria parasites that developed a resistance to previous drugs are “suspected to have contributed to millions of additional malaria deaths in young African children in the 1980s”.

When the first malaria drug, chloroquine, was developed, researchers thought that the disease would be eradicated within years.

But since the 1950s the parasites have evolved to develop resistance to successive drugs.

This is a deeply worrying and highly significant moment. Today marks a setback in the fight against the malaria.

Resistance to artemisinin is not new as it has been in parts of South East Asia for more than a decade.

In some regions there, 80% of patients are now infected with malaria parasites that resist treatment.

But Africa has always been the biggest concern – it is where more than nine in 10 cases of the disease are.

It appears as though the resistance evolved in malaria parasites in Africa rather than spreading from South East Asia to the continent.

The result, however, is the same – malaria is getting harder to treat.

Malaria infection is now commonly treated with a combination of two drugs – artemisinin and piperaquine.

But then malaria parasites started developing a resistance to artemisinin as well – this was first recorded in 2008 in South East Asia.

At the time scientists they feared that resistance to artemisinin could also occur in Africa and have devastating consequences

The research indicates that these fears may have been realised.

In 2018, African countries accounted for over 90% of the more than 400,000 deaths from malaria recorded.

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Professor Lang Linfu, who was one of the scientists involved in its discovery of artemisinin, explains how he made the breakthrough.

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Media captionProfessor Lang Linfu

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Coronavirus Malaria

Coronavirus: Malaria drug hydroxychloroquine ‘does not save lives’ – BBC News

Anti-malarial drugs

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Hydroxychloroquine received global attention after being taken by Donald Trump

A malaria drug that has been tested as a treatment for coronavirus does not save lives, one of the world’s largest trials shows.

Hydroxychloroquine received global attention after being promoted by Donald Trump, and then controversy after studies on it were retracted.

The drug has now been pulled from the UK’s Recovery trial, which is run by the University of Oxford.

The findings have been passed on to the World Health Organization.

Back at the start of the pandemic, laboratory studies had suggested the malaria drug could affect the virus. Small-scale studies in China and France then hinted it might help patients.

There was a huge amount of hope, as the medicine is cheap and has been safely used to treat malaria and conditions such as lupus and arthritis.

However, the evidence supporting its use for coronavirus has been weak.

‘Not a treatment for Covid’

That is why the data from the Recovery trial is crucial. It is the first to test the drug in large numbers of people in a thorough clinical trial.

More than 11,000 patients with Covid-19 are taking part, with 1,542 patients given hydroxychloroquine.

Due to mounting controversy about the drug, the UK’s drugs regulator last night asked the Oxford researchers to review their data.

The results showed 25.7% of people taking hydroxychloroquine had died after 28 days. This compared with 23.5% who were given standard hospital treatment.

“This is not a treatment for Covid,” said Prof Martin Landray, part of the Recovery trial. The trial immediately stopped using the drug.

The findings come in the wake of deep concern in academic publishing that led to an article being retracted in the Lancet – one of the world’s most prestigious medical journals.

It had published a study involving nearly 15,000 patients, from hundreds of hospitals, given hydroxycholoroquine or the similar drug chloroquine.

It concluded the drug was not beneficial and increased the risk of irregular heart rhythms and death. That publication led to the WHO suspending its trials of the anti-malaria drug.

The data had been collected from hospitals by the little-known healthcare firm Surgisphere.

‘Disappointing’

Concerns were raised about the data and then some of the study’s authors said they could no longer stand by their publication as Surgisphere would not allow an independent review.

Then the New England Journal of Medicine retracted another paper that had data based on Surgisphere.

Prof Peter Horby, from the University of Oxford which runs the Recovery trial, said: “Hydroxychloroquine and chloroquine have received a lot of attention and have been used very widely to treat Covid patients despite the absence of any good evidence.

“Although it is disappointing that this treatment has been shown to be ineffective, it does allow us to focus care and research on more promising drugs.”

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