Malaria becomes resistant to treatment in Africa
Malaria is a serious tropical disease spread by mosquitoes. If it isn’t diagnosed and treated promptly, it can be fatal. However, it is preventable and curable.
The World Health Organisation (WHO) estimated the number of malaria deaths in 2019 at 409,000, with children under 5 accounting for the majority of deaths (274,000 in 2019 – 67% of the total).
News this week that a vaccine is becoming available is welcome, especially as it has been in development for 30 years. The long development time was because the parasite has numerous different life stages and each can adapt to become resistant to treatment.
Current treatments
Until the vaccine becomes more widely available, the fight against malaria is focussed on prevention as much as treatment. Two main forms of prevention are used; insecticide-treated mosquito nets and anti-malarial drugs.
For travellers, malaria can be prevented through chemoprophylaxis, which suppresses the blood stage of malaria infections, thereby preventing malaria disease.
However, resistance to antimalarial medicines is a huge and recurring problem. Resistance to medicines widely used in the past, such as chloroquine, become widespread in the 1950’s and 60’s.
The most commonly used drug today, artemisinin, earned a Nobel prize for the Chinese scientist who discovered it in 1972. Sadly, treatment resistant strains of mosquito started to be discovered in the Greater Mekong region in 2013 and the drug has become steadily less effective in Asia. Pockets of resistance have emerged independently across the region ever since.
Resistant strains found in Africa
The malaria parasite that infects humans (Plasmodium falciparum) has now developed resistance to artemisinin across China, Cambodia, Laos, Vietnam, Myanmar and Thailand. Resistance in other regions, particularly Africa, would be a big problem.
Now a team of scientists funded by the Japan Society for the Promotion of Science has released the results of a two-year field study in Northern Uganda, which was looking for signs of resistance to artemisinin.
Sadly, they have found resistance has independently emerged and is starting to spread in Africa too. They also identified a genetic marker for the resistance, which may help in the detection of the resistant parasites.
The vaccine schedule
Given that the African region accounted for 94% of all malaria cases and deaths in 2019, this is a potentially very large problem.
This makes news of the coming malaria vaccine especially welcome. In the meantime, if you are planning on travelling to Africa or have employees travelling in the region, it is wise to take as many precautions as possible.
Reports suggest the vaccine may become widely available between 2022 and 2023, however, it is likely to take many years before any degree of herd immunity may be possible.
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