Continued vigilance against drug-resistance malaria is needed

Jul 08, 2009

Current combination malaria therapies recommended by the World Health Organisation (WHO) provide adequate treatment for mild malaria, according to a Cochrane Systematic Review of the evidence. However, selected trials had high failure rates for some combinations and evidence for the effectiveness of anti-malarial therapies is lacking in some vulnerable groups.

Malaria kills more than a million people each year and accounts for more than a third of public health expenditure in some badly affected countries. Uncomplicated malaria is a mild version of the disease, but it can become serious and life threatening if left untreated. Resistance to the older antimalarials has led the WHO to recommend treatments combining an artemisinin-based drug with another longer-lasting drug to combat resistance.

The review included 50 trials of artemisinin-based combination therapies (ACTs). Overall, the four combinations studied were effective for treatment of the most common type of malarial parasite. The researchers conclude that the recently introduced dihydroartemisinin-piperaquine performed well compared to the ACTs in current use and offers another potential first-line therapy for the disease.

There were examples of treatment failure rates above 10% for all evaluated combinations. This is above the maximum allowable failure rate for a first line antimalarial as recommended by the WHO.

"Patterns of resistance change from place to place and over time, so these results have to be interpreted with some caution," says lead researcher David Sinclair of the Liverpool School of Tropical Medicine in Liverpool, UK. "Our findings emphasise the need for continued vigilance in the monitoring of and the development of resistance to antimalarial drugs."

In addition, there were few studies focusing on the most at-risk groups, which are pregnant women and young infants. "The lack of evidence supporting the use of these drugs in pregnant women and infants represents a critical gap in our knowledge that must be addressed," says Sinclair.

Source: Wiley (news : web)

Explore further: New analysis questions use of acute hemodialysis treatment

add to favorites email to friend print save as pdf

Related Stories

Rectal artemisinins rapidly eliminate malarial parasites

Mar 28, 2008

Artemisinin-based suppositories can help ‘buy time’ for malaria patients who face a delay in accessing effective, injectable antimalarials, according to research published in the online open access journal BMC Infectious Di ...

Researchers discover surprising drug that blocks malaria

Jan 16, 2007

Northwestern University researchers have discovered how malaria parasites persuade red blood cells to engulf them -- and how to block the invading parasites. The malaria marauders hack into the red cell's signaling system ...

Recommended for you

New analysis questions use of acute hemodialysis treatment

51 minutes ago

A common approach to treating kidney failure by removing waste products from the blood did not improve survival chances for people who suddenly developed the condition, in an analysis led by experts at the University of Pittsburgh ...

WHO: West Africa Ebola death toll rises to 1,350

1 hour ago

Security forces acting on the president's orders used scrap wood and barbed wire to seal off 50,000 people inside their crowded slum Wednesday in an attempt to contain the Ebola outbreak, which has killed ...

User comments : 0