Treatment resistant Malaria spreads to Africa
By: OH Assessment Ltd
Malaria is a serious disease spread by mosquitoes. If it isn't diagnosed promptly, it can be fatal.
The World Health Organisation (WHO) estimated the number of malaria deaths in 2019 at 409,000, with children under 5 accounting for the majority (274,000 in 2019 – 67%).
News this week that a vaccine is available is welcome, especially as it has been in development for 30 years. The development time was because the parasite has different life stages and each can adapt to become resistant to treatment.
Until the vaccine becomes more widely available, the fight against malaria is focussed on prevention as much as treatment. Two main forms of prevention are used; insecticide-
For travellers, malaria can be prevented through chemoprophylaxis, which suppresses the blood stage of malaria infections, preventing malaria disease.
However, resistance to antimalarial medicines is a huge problem. Resistance to medicines used in the past, like chloroquine, become widespread in the 1960's.
The most commonly used drug, artemisinin, earned a Nobel prize for the scientist who discovered it in 1972. Sadly, treatment resistant strains of mosquito were discovered in the Greater Mekong in 2013 and the drug has become steadily less effective in Asia. Pockets of resistance have emerged across the region ever since.
Resistant strains found in Africa
The malaria parasite (Plasmodium falciparum) has now developed resistance to artemisinin across China, Cambodia, Laos, Vietnam, Myanmar and Thailand. Resistance in other regions, particularly Africa, would be a big problem.
Now a team of scientists funded by the Japan Society for the Promotion of Science has released the results of a two-year field study in Northern Uganda, which was looking for signs of resistance to artemisinin.
Sadly, they have found resistance has independently emerged and is starting to spread in Africa. They also identified a genetic marker for the resistance, which may help in the detection of the resistant parasites.
The vaccine schedule
Given that the African region accounted for 94% of all malaria cases and deaths in 2019, this is a potentially very large problem.
This makes news of the coming malaria vaccine especially welcome. In the meantime, if you are planning on travelling to Africa or have employees travelling in the region, it is wise to take as many precautions as possible.
Reports suggest the vaccine may become widely available between 2022 and 2023, however, it is likely to take many years before any degree of herd immunity may be possible.
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