More than half the world’s people are at risk of malaria infection
By Kate Kelland
LONDON, Feb 2 (Reuters) – Multidrug-resistant malaria superbugs have taken hold in parts of Thailand, Laos and Cambodia, threatening to undermine progress against the disease, scientists said.
The superbugs – malaria parasites that can beat off the best current treatments, artemisinin and piperaquine – have spread throughout Cambodia, with even fitter multidrug resistant parasites spreading in southern Laos and northeastern Thailand.
“We are losing a dangerous race to eliminate artemisinin resistant…malaria before widespread resistance to the partner antimalarials makes that impossible,” said Nicholas White, a professor at Oxford University in Britain and Mahidol University in Thailand who co-led the research.
“The consequences of resistance spreading further into India and Africa could be grave if drug resistance is not tackled from a global public health emergency perspective.”
More than half the world’s people are at risk of malaria infection. Most victims are children under five living in the poorest parts of sub-Saharan Africa.
Recent progress against the mosquito-borne disease has been dramatic and numbers falling ill have been significantly reduced, but it still kills more than 420,000 people each year, the World Health Organization says.
Malaria specialists worldwide say emerging drug resistance in Asia is now one of the most serious threats to that progress.
From the late 1950s to the 1970s, chloroquine-resistant malaria parasites spread across Asia and then into Africa, leading to a resurgence of malaria cases and millions of deaths.
Chloroquine was replaced by sulphadoxine-pyrimethamine (SP), but resistance to SP subsequently emerged in western Cambodia and again spread to Africa.
The fear now is that the same pattern of resistance spread and the resurgence will repeat itself.
“We now see this very successful resistant parasite lineage emerging, outcompeting its peers, and spreading over a wide area,” said Arjen Dondorp, of the Mahidol Oxford Tropical Medicine Research Unit in Thailand, who co-led the work.
Efforts to control malaria in Asia must be stepped up urgently “before it becomes close to untreatable”.
In their study in the Lancet Infectious Diseases journal, the scientists said that after examining blood samples from malaria patients in Cambodia, Laos, Thailand and Myanmar, they found that a single mutant parasite lineage, known as PfKelch13 C580Y, has spread across three countries, replacing parasites containing other, less artemisinin-resistant mutations.
They explained that while the C580Y mutation does not necessarily make the parasite more drug-resistant, it does have other qualities that make it more risky – notably it appears to be fitter, more transmissible and able to spreading more widely.
(Reporting by Kate Kelland; Editing by Angus MacSwan)
Published by Jalal Saleh Michika, PhD, MSc, DM, MBBS, MACE, FACP
Jalal Saleh Michika, PhD, is a Consultant Public Health Physician/Epidemiologist from Nigeria. He received his trainings from University Of Maiduguri Nigeria (MD), Imperial College London (Dip. Internal Medicine), London School Of Hygiene and Tropical Medicine (MSc Public Health), and the Walden University U.S.A. (PhD Public Health Epidemiology).
The author is a National Professional Officer - Malaria, World Health Organisation Nigeria.
The author’s doctoral dissertation is on “Prevalence of Neonatal Tetanus in Northeastern Nigeria.”
Dr. Saleh holds fellowship and membership of various professional bodies that includes:
American College Of Epidemiology (Member)
American Public Health Association (Fellow)
American Society for Tropical Medicine and Hygiene (Member)
Royal Society for Public Health (Fellow)
Royal Society for Tropical Medicine and Hygiene (Fellow)
Golden Key International Honor Society (Member)
International Society for Disease Surveillance (Member)
International Society for Infectious Diseases (Member)
International Epidemiological Association (Member)
Individual Member, Collaboration on Health and Environment, U.K.
Nigerian Institute for Management Consultants (Member)
Nigerian Institute of Management (Member)
The author has published several peer-reviewed articles in reputable medical journals:
1. Polio eradication in Nigeria: evaluation of the quality of acute flaccid paralysis surveillance documentation in Bauchi state, 2016 (BMC Public Health, 2018, 18(Suppl 4):1307 https://doi.org/10.1186/s12889-018-6185-z)
2. Quality Assurance (QA) Tool in Public Health Campaigns: A Look at the 2017 LLIN Replacement Campaign in Nigeria (Open Access Library Journal, 2018, 5: e4701. https://doi.org/10.4236/oalib.1104701)
3. Lots Quality Assurance Survey (LQAS) as a Strategy to Achieving Quality LLIN Campaigns: The Nigerian Experience (Open Access Library Journal, 2018, 5: e4484. https://doi.org/10.4236/oalib.1104484)
4. LLIN Ownership, Utilization, and Malaria Prevalence: An Outlook at the 2015 Nigeria Malaria Indicator Survey (Open Access Library Journal, 2018, 5: e4280. doi.org/10.4236/oalib.1104280)
5. Investigation of a Suspected Malaria Outbreak in Sokoto State, Nigeria, 2016 (Open Access Library Journal, 2017, 4: e4246. doi.org/10.4236/oalib.1104246)
6. Antenatal care services and neonatal tetanus: an outlook at the northeastern Nigeria (Elsevier, Paediatric Infectious Diseases Journal, 2015, dx.doi.org/10.1016/j.pid.2015.03.001)
7. The Role of Dashboards in Long Lasting Insecticidal Nets (LLIN) Campaigns: A Pilot Report from Nigeria (J Community Med Public Health, 2018, CMPH-134. DOI:10.29011/2577-2228/100034)
8. Intensified Routine Immunization (RI) Activities: A Strategy for Improving RI and AFP Surveillance outcomes; Lessons from Abia State Nigeria (J Community Med Public Health, 2018, CMPH-132. doi:10.29011/2577-2228/100032)
9. Trends of measles in Nigeria: A systematic review (Sahel Med J 2016; 19:5-11. doi:10.4103/1118-8561.181887)
10. Relationship between Caregivers' Socio-Economic Status and Childhood Tuberculosis in Bauchi State, Northeastern Nigeria. (WebmedCentral INFECTIOUS DISEASES 2018;9(6): WMC005487. URL http://www.webmedcentral.com/article_view/5487)
11. A critical look at 2015 acute flaccid paralysis (AFP) surveillance core indicators of Bauchi state, Nigeria (Science Journal of Public Health, 2016:4(4), 326-329. doi: 10.11648/j.sjph.20160404.19)
12. Behaviour of People Living with HIV Aids in Northeastern Nigeria (Open Access Library Journal, 2017, 4: e3944. doi.org/10.4236/oalib.1103944)
13. Factors behind low NPENT rate in Bauchi State in 2015 (Science Journal of Public Health, 2016:4(4), 342-345.
doi: 10.11648/j.sjph.20160404.21)
14. Performance of acute flaccid paralysis surveillance in Bauchi state, Nigeria, 2016 (Journal of Public Health Informatics. ISSN 1947-2579. http://ojphi.org. 9(1): e182, 2017)
15. An Evaluation of the Integrated Disease Surveillance and Response (IDSR) in Enugu State, Nigeria (Journal of Health Medicine and Nursing 2018, 48. ISSN 2422-8419, http://iiste.org/Journals/index.php/JHMN/article/view/41699)
16. Neonatal tetanus elimination and the Nigerian health system: where is the missing link? (Science Journal of Public Health, 2015; 3(3): 417-422. doi: 10.11648/j.sjph.20150303.28)
17. Do traditional birth attendants (TBAs) have a role in the prevention of neonatal tetanus (American Journal of Health Research, 2015;3(3), 189-193. doi: 10.11648/j.ajhr.20150303.24)
18. Prevalence of neonatal tetanus in the northeastern Nigeria (Journal of Health Medicine and Nursing 2015, 15. ISSN 2422-8419 Retrieved from http://iiste.org/Journals/index.php/JHMN/article/view/24447)
19. Barriers to HIV/AIDS treatment in Nigeria (American Journal of Health Research, 2015; 3(5): 305-309. doi: 10.11648/j.ajhr.20150305.17)
20. Globalization and the spread of multi-drug resistant Tuberculosis (Journal of Health, Medicine and Nursing 2015, 18. ISSN 2422-8419, http://iiste.org/Journals/index.php/JHMN/article/view/25854/26286)
21. Gender disparity and NNT (European Journal of Preventive Medicine, 2015; 3(3): 71-74. doi: 10.11648/j.ejpm.20150303.16)
22. Incorporating tele-health into disease surveillance (Science Journal of Public Health, 2015:3(4), 583-587. doi: 10.11648/j.sjph.20150304.28)
23. Impact of hygienic caring of the umbilical cord in the prevention of neonatal tetanus (WebmedCentral PUBLIC HEALTH 2015; 6(5):WMC004891. URL http://www.webmedcentral.com/article_view/4891)
24. Malaria vaccine: the pros and cons (Nigerian Journal of Medicine, 2010; 19(1): 8-13 doi: http://dx.doi.org/10.4314/njm.v19i1.52464)
25. Acute pulmonary embolism (Nigerian Journal of Medicine, 16(1): 2007; 11-17 doi: http://dx.doi.org/10.4314/njm.v16i1.37274)
26. Role of HPV vaccine in the prevention of cervical cancer (J Interdiscipl Histopathol 2013; 1(4): 212-216 doi: 10.5455/jihp.20130119122700)
27. TB in HIV patients: strengthening control measures (Nigerian Medical Practitioner, 2011; 59(5-6), 56-61 doi: http://dx.doi.org/10.4314/nmp.v59i5-6.70363)
28. Pharmacotherapy for chronic heart failure (Nigerian Journal of Medicine, 2007; 16(2) 102-106 doi: http://dx.doi.org/10.4314/njm.v16i2.37290)
29. The role of Bosentan in pulmonary arterial hypertension (Nigerian Medical Practitioner, 2007; 51(4), 64-70 doi: http://dx.doi.org/10.4314/nmp/v51i4.28844)
30. Role of Iloprost and Bosentan in pulmonary arterial hypertension (Nigerian Journal of Medicine, 2007; 17(1), 13-19 doi: http://dx.doi.org/10.4314/njm.v17i1.37347)
31. Concurrent therapy in asthma (Nigerian Journal of Medicine, 2006; 15(4), 359-363 doi: http://dx.doi.org/10.4314/njm.v15i4.37247)
32. Combination therapy in asthma (Nigerian Journal of Medicine, 2008; 17(3), 238-243 doi: http://dx.doi.org/10.4314/njm.v17i3.37377)
33. Combination therapy in type 2 diabetes mellitus (Nigerian Hospital Practice, 2009; 3(3), 25-29 doi:
http://dx.doi.org/10.4314/nhp.v3i3-4.45415)
34. Prevention of diabetic nephropathy (Nigerian Medical
Practitioner, 2008; 53(3), 28-33 doi:
http://dx.doi.org/10.4314/nmp.v53i3.28925)
35. Towards elimination of maternal and neonatal tetanus in the developing countries: a look at the theory of planned behavior (European Journal of Preventive Medicine, 2015; 3(4), 110-116. doi: 10.11648/j.ejpm.20150304.13)
36. The future of health informatics and electronic health records: a look at the Canadian surveillance systems and electronic health records (Journal of Medicine, Physiology and Biophysics, 2015, 14. ISSN 2422-8427, http://iiste.org/Journals/index.php/JMPB/article/view/22972)
37. How to build a nest for success in the public health Sector: a critical look at the leadership theories (Journal of Humanities and Social Sciences, 2015; 3(4): 133-139. doi: 10.11648/j.hss.20150304.12)
38. Public health leadership theory in immunization campaigns: a look at the transactional and transformational leaderships (Journal of Health Medicine and Nursing, 2015, 15. ISSN 2422-8419, http://iiste.org/Journals/index.php/JHMN/article/view/24448)
39. Assessing the Knowledge, Practice and Attitudes (KPA) of Traditional Healers in Malaria Control Programme in Nsukka Zone of Enugu State Nigeria (Journal of Health Medicine and Nursing, 2018, 49. ISSN 2422-8419, http://iiste.org/Journals/index.php/JHMN/article/view/42048/43291)
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