Artemether-Lumefantrine, one of the trusted malaria drug combinations, has been unable to cure four patients who all visited Africa, according to the BBC. Until now, the drug had been hailed as an effective formula for malaria treatment.
A report published in the journal Antimicrobial Agents and Chemotherapy showed that the artemisinin-based combination therapy failed the patients who were monitored between October 2015 and February 2016.
The report said the group initially responded to the therapy, got better, and were sent home but they all had to be readmitted a month later after the malaria made a comeback. They eventually made full recoveries after being treated with other therapies.
In his comments, Dr. Colin Sutherland of the London School of Hygiene and Tropical Medicine described the report as “remarkable.”
“It’s remarkable there’s been four apparent failures of treatment; there’s not been any other published account. It does feel like something is changing, but we’re not yet in a crisis.”
With all four patients in the study having previously traveled to Africa, speculation is arising about whether a new drug-resistant strain of the malaria parasite has emerged on the continent.
“There has been anecdotal evidence in Africa of treatment failure on a scale that is clinically challenging. We need to go in and look carefully at drug efficacy,” Dr. Sutherland added.
Malaria is caused by blood parasites, and it is spread by the bite from an infected female anopheles mosquito. In the absence of prompt and effective treatment, malaria can result in death. Most cases of infection (88 percent) and death (90 percent) from malaria occur in Africa, making it one of the most important challenges for health care providers on the continent. In 2015 alone, the disease killed an estimated 300,000 African children.
One of the reasons why the malaria parasite remains such a daunting challenge for health authorities lies in its ability to quickly develop resistance to anti-malarial drugs.
Malaria, A Daunting Challenge
For example, the anti-malarial drug Chloroquine was introduced in 1945 only for the malarial parasite to develop a resistance to it 12 years later. The drugs Sulfadoxine Pyrimethamine and Mefloquine were later introduced in 1967 and 1977, respectively, only for the parasite to develop resistance again. Much of today’s frontline treatments consist of the artemisinin-based combination therapy, which now also appears to be meeting resistance.
Still, a team at the London School of Hygiene and Tropical Medicine said it was perhaps too early to panic, but it warned things could suddenly get worse and demanded an urgent appraisal of drug- resistant levels in Africa.
In more cheerful news, a team of researchers working on a malarial vaccine announced in January that they have passed a “critical milestone” in human safety trials. The team of scientists at the Center for Infectious Disease Research in Seattle say they used a genetically modified form of malaria that was unable to cause a full infection in people.
Early trials have suggested it was safe as it demonstrated and generated a good immune response, with leading tropical disease experts describing the findings as “promising.”