Malaria Report: New Strains, New Treatments, New Counterfeits

Three new studies highlight the hopes and fears of parents across the globe.  

A new study conducted by Dr. Nicholas White of Mahidol University in Bangkok, Thailand shows a significant reduction in mortality and gives hope for children with severe malaria.  

Meanwhile a study from the U.S. Agency for International Development details the pervasive infiltration of ineffective counterfeit malarial drugs.

And another study by researchers of malaria in Indonesia has found a new genetic mutation in the disease.

Three new studies highlight the hopes and fears of parents across the globe.  A new study shows a significant reduction in mortality and gives hope for children with severe malaria.  A study from USAID details the pervasive infiltration of ineffective counterfeit malarial drugs.  And another study of malaria in Indonesia has found a new genetic mutation in the disease.

Medical News Today reports that artesunate decreases mortality among children with severe falciparum malaria by nearly a quarter relative to quinine, the current standard treatment for the disease. The study was conducted by Dr. Nicholas White of Mahidol University in Bangkok, Thailand, and will be published in The Lancet before being presented at a meeting of the American Society for Tropical Medicine and Hygiene.

The effectiveness of the new treatment, however, is reportedly hindered by the prevalence of counterfeit drugs. “Simply changing treatment recommendations is not enough- the drug [artesunate] has to be made available,” said Dr. G. Dennis Shanks of the Australian Army Malaria Institute and University of Queensland School of Population Health in a comment linked to the initial findings. He added that increased vigilance to stop the manufacture and distribution of counterfeit medications in Africa is necessary alongside efforts to promote the use of artesunate as a treatment for malaria.

U.S. Agency for International Development (USAID) has reported that substandard and counterfeit versions of thirteen antimalarial drugs have been discovered throughout Ghana by the Medicines Quality Monitoring surveillance program set up by the Ghana Food and Drugs Board in collaboration with the U.S. Pharmacopeial Convention (USP).  

“Few people fully realize the devastation that distribution of substandard or counterfeit medications can wreak on vulnerable populations,” said Stephen Opuni, M.D., chief executive officer of the FDB. “In this case some of the drugs discovered contained no active pharmaceutical ingredient, while others failed to meet required quality standards. This causes great harm in two ways: the individual patients taking the drugs get no relief, and drug-resistant strains of malaria may grow stronger.

The discovery of the counterfeits, in use at a government-run hospital and private clinic, and being distributed through many pharmacies, has resulted in a nationwide recall of all thirteen drugs, including publicizing the names of the outlets where they were found. 

According to the World Health Organization, falciparum malaria is the deadliest of the four strains of malaria that affect human beings. It reportedly causes the death of one African child every 45 seconds and is responsible for 20 percent of childhood deaths in Africa overall. One out of every six children admitted to a hospital with falciparum malaria will die of the disease, in addition to the unknown numbers of children who die from the illness at home.

The study on artesunate was carried out in nine African countries on 5,425 children who had contracted falciparum malaria. Half were treated with artesunate and half received quinine. The study found that mortality was reduced from 11 percent among quinine patients to 8.5 percent among those treated with artesunate, representing a 22.5 percent reduction.

According to the source, artesunate also resulted in a decrease in the percentage of patients who suffered from adverse side effects to the treatment, reducing rates of low blood sugar, coma and convulsions as well as the number of patients in comas who experienced a deterioration of their coma scores.

In Indonesia, researchers studied malaria endemicities in Central Java, Sumatera and North Molluca. They discovered a mutant allele which they are currently testing for pyrethroid resistance.  The spread of resistance to the currently available anti-malarial drugs and mosquito insecticides would cause greater malarial infection.   Their research was published in the Malarial Journal, 2010, 9:315.