Researchers on Thursday reported the first clinical evidence that drug-resistant mutations of the parasite responsible for malaria were gaining ground in Africa.
Experts have long worried about the emergence of drug resistance across the continent and a new study published in medical journal The Lancet appeared to confirm those fears.
In clinical trials, the disease lingered longer in children receiving standard treatment for malaria if they were infected with mutant strains of the disease, the study found.
The efficacy of Artemisinin-based combination therapy (ACT) remained high, but researchers said there was an "urgent need" for scrutiny in Rwanda, where the study was conducted, as well as in neighbouring countries.
There are an estimated 229 million cases of malaria worldwide, the World Health Organisation said. The disease killed more than 400,000 people in 2019, more than two thirds of them children.
Malaria is caused by the Plasmodium falciparum parasite, which is carried by females mosquitos from any of several dozen species in the genus Anopheles.
"Our study shows that resistant isolates are starting to become more common," said lead author Aline Uwimana, a researcher at the Rwanda Biomedical Centre in Kigali.
Introduced in the early 2000s, ACT is the most effective and widely used treatment for malaria.
The medication combines an artemisinin component that clears most of the pathogens from the patient's body within three days, and a long-acting partner drug that destroys the remaining parasites.
Resistance to the artemisinin component is suspected if P. falciparum is still present beyond the third day of treatment.
Currently, 10 mutations in one of the parasite's genes, known as pfk13, are confirmed as markers of partial resistance, and several others are tagged as potential markers.
Partial artemisinin resistance was first identified in Cambodia in 2008, and is today well-documented in many south-east Asian countries.
Evidence from the Mekong region shows that once artemisinin resistance becomes prevalent, resistance to the partner drug often follows, resulting in ACT failure.
In 2006, Rwanda introduced the most widely used antimalarial as its main treatment for the disease.
A study in 2013 and 2014 showed some mutations, but no evidence that the drug combination was less effective.
Follow-up research in 2018, however, showed for the first time mutations in the pfk13 gene and so-called delayed parasite clearance in patients, though ACT effectiveness remained above the critical threshold of 90 per cent.
In the trial, more than 200 children aged six months to five years infected by the parasite received three-day standard treatment, and were then monitored for 28 days.
Parasites were found in bout 15 per cent of the children three days after treatment.
"Recent data suggests that we are on the verge of clinically meaningful artemisinin resistance in Africa," Philip Rosenthal, a professor at the University of California in San Francisco, wrote in The Lancet.
Loss of efficacy of key ACTs "may have dire consequences, as occurred when chloroquine resistance led to enormous increases in malaria deaths in the late 20th century," he said.
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Killing of Qassem Suleimani
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Courtesy: Crystal Intelligence
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More on Quran memorisation:
ESSENTIALS
The flights
Emirates, Etihad and Swiss fly direct from the UAE to Zurich from Dh2,855 return, including taxes.
The chalet
Chalet N is currently open in winter only, between now and April 21. During the ski season, starting on December 11, a week’s rental costs from €210,000 (Dh898,431) per week for the whole property, which has 22 beds in total, across six suites, three double rooms and a children’s suite. The price includes all scheduled meals, a week’s ski pass, Wi-Fi, parking, transfers between Munich, Innsbruck or Zurich airports and one 50-minute massage per person. Private ski lessons cost from €360 (Dh1,541) per day. Halal food is available on request.
Mobile phone packages comparison
SPECS
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PROFILE
Name: Enhance Fitness
Year started: 2018
Based: UAE
Employees: 200
Amount raised: $3m
Investors: Global Ventures and angel investors
Company: Instabug
Founded: 2013
Based: Egypt, Cairo
Sector: IT
Employees: 100
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Mubadala World Tennis Championship 2018 schedule
Thursday December 27
Men's quarter-finals
Kevin Anderson v Hyeon Chung 4pm
Dominic Thiem v Karen Khachanov 6pm
Women's exhibition
Serena Williams v Venus Williams 8pm
Friday December 28
5th place play-off 3pm
Men's semi-finals
Rafael Nadal v Anderson/Chung 5pm
Novak Djokovic v Thiem/Khachanov 7pm
Saturday December 29
3rd place play-off 5pm
Men's final 7pm
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UAE currency: the story behind the money in your pockets
Key facilities
- Olympic-size swimming pool with a split bulkhead for multi-use configurations, including water polo and 50m/25m training lanes
- Premier League-standard football pitch
- 400m Olympic running track
- NBA-spec basketball court with auditorium
- 600-seat auditorium
- Spaces for historical and cultural exploration
- An elevated football field that doubles as a helipad
- Specialist robotics and science laboratories
- AR and VR-enabled learning centres
- Disruption Lab and Research Centre for developing entrepreneurial skills
