The UK is reporting that for the first time, some cases of malaria have failed to be cured by a commonly used drug.
Malaria (plasmodium infection) is a life-threatening blood disease. It is caused by a parasite that is spread by infected mosquitoes. Malaria caused 438,000 deaths worldwide in 2015, mostly children in Africa.
Malaria is normally preventable and curable. Artemether-lumefantrine (AL) is a first-line treatment that is usually highly effective.
But in four recent cases, patients who initially recovered were later found to be infected with new strains of the plasmodium parasite. These are the first documented cases in the UK of AL failing to cure malaria. All four patients had travelled to Africa, and all four cases occurred within a short time period (between October 2015 and February 2016).
Though inconclusive, medical professionals believe these malaria strains demonstrate reduced susceptibility, a precursor to drug resistance.
“The parasites we describe may represent adaptive African genotypes that have evolved,” the researchers write. “The current practice of three days of treatment may therefore be insufficient to guarantee clearance of parasite genotypes.”
Agilent is involved in research work involving both malaria and its treatment.
Malaria in many African countries has decreased thanks for control intervention programs. However, U.S. and Kenyan health experts found that more than 80 percent of a population sample in Kenya still tested positive for submicroscopic levels of plasmodium. Children 5 to 15 years old were most likely to be carriers of the parasite. The researchers employed advanced genomics technologies, including an Agilent qPCR system, to detect parasite gametocytes.
Researchers in the U.S. and India are using next-generation sequencing to surveil and detect emerging drug resistance in plasmodium. Their protocol includes an Agilent TapeStation system and high-sensitivity reagents.
Researchers in Ghana examined several brands of artemether-lumefantrine for counterfeit or substandard ingredients. Actual amounts of both artemether and lumefantrine varied anywhere from 93 to 111 percent of stated content, while one brand failed International Pharmacopoeia content requirements. The researchers used an Agilent HPLC with a variable wavelength detector “due to its sensitivity, accuracy, and precision.”
For more information go to:
- Malaria (Centers for Disease Control)
- Pfk13-independent treatment failure in four imported cases of Plasmodium falciparum malaria given artemether-lumefantrine in the UK
- Assessment of submicroscopic infections and gametocyte carriage of Plasmodium falciparum during peak malaria transmission season in a community-based cross-sectional survey in western Kenya, 2012
- A Method for Amplicon Deep Sequencing of Drug Resistance Genes in Plasmodium falciparum Clinical Isolates from India
- Quality Assessment of Artemether-Lumefantrine Samples and Artemether Injections Sold in the Cape Coast Metropolis
- Agilent Genomics Solutions