An
international team of scientists are launching a major study of drug-resistant
malaria in Myanmar.
Myanmar, long an isolated
sovereign state, ended military rule last year and as it gradually opens up to
the world, an international team of scientists coordinated by the World Health
Organization (WHO) are launching a major study of potentially deadly
drug-resistant malaria, a major problem in Southeast Asia.
In two
studies published by other scientists in April 2012, a new type of
drug-resistant malaria was identified along the border between Thailand and
Myanmar, and a major genomic region underlying the drug resistance was found.
Now, the WHO-led team aims to
develop tests to identify and track the spread of the artemisinin-resistant
malaria in Myanmar and Southeast Asia using the new molecular markers they have
identified.
Malaria is caused by a parasite
transmitted in the bite of a mosquito. The disease causes fevers and other
symptoms that can lead to coma and even death. There were 216 million cases of
malaria globally and 655,000 deaths in 2010, according to the WHO.
Artemisinin-resistant malaria is a new type of resistant malaria that reacts
slowly to the artemisinin group of drugs, a first-line treatment against the
deadly disease.
“Myanmar has about three percent
of the Southeast Asian population, but about 20 percent of the region’s
malaria,” says Dr. Christopher Plowe, leader of the Malaria Group at the
University of Maryland School of Medicine’s Center for Vaccine Development. Dr.
Plowe works closely with his wife, Dr. Myaing Myaing Nyunt, a Myanmar native
and assistant professor at the Johns Hopkins Bloomberg School of Public Health.
Myanmar is particularly
significant in the study of drug-resistant malaria because malaria cases are
found throughout the country, unlike in Thailand, where the center of the
nation is malaria-free, forming a potential barrier against the disease’s
spread. Myanmar’s high rate of infection paves a path for resistance to spread
to and from neighboring nations, Dr. Plowe explains.
“Artemisinins are our newest
group of effective anti-malaria drugs and our first line of defense against
this parasite, representing a huge global investment in the fight against the
disease. This emerging form of artemisinin-resistant malaria, while it’s still
relatively rare, is already causing treatment failures where it first appeared,
in Cambodia. The concern is that we’ll lose this drug, at an immense cost of
human life.”
Building upon earlier research
into the genomic region underlying artemisinin resistance, the team led by Dr.
Plowe now reports in the journal, the Proceedings of the National
Academy of Sciences (PNAS), the identification of four promising
molecular markers for artemisinin-resistant malaria.
Clinical trials of artemisinin
efficacy were conducted by researchers working in Bangladesh, Western Cambodia,
and areas of northern Thailand near the border with Myanmar. Using samples from
the clinical trial, the researchers tested mutations throughout the malaria
genome to see if they were associated with clinical resistance.
“If these markers turn out to be
predictive, we can use them to track the spread of drug resistance and to help
guide the malaria control program in affected countries. We want to focus
limited resources on artemisinin resistance to try to stop it in its tracks
before it spreads,” says Dr. Plowe.
In addition to tracking the
spread of artemisinin-resistant malaria, the scientists will train local
investigators in cutting-edge molecular and pharmacology lab practices to help
their country cope with the problem.
The article can be found
at: Takala-Harrison S et
al. (2012) Genetic loci associated with delayed clearance of Plasmodium
falciparum following artemisinin treatment in Southeast Asia.
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