LONDON—
Malaria-carrying parasites in parts of Cambodia have
developed resistance to a major drug used to treat the disease in Southeast
Asia, according to research published on Thursday in The Lancet Infectious Diseases journal.
The drug piperaquine, used in combination with the drug
artemisinin, has been the main form of malaria treatment in Cambodia since
2008.
The combination is also one of the few treatments still
effective against multi-drug-resistant malaria which has emerged in Southeast
Asia in recent years, and which experts fear may spread to other parts of the
world.
"[Treatment] failures are caused by both artemisinin
and piperaquine resistance, and commonly occur in places where
dihydroartemisinin-piperaquine has been used in the private sector,"
researchers said. Artemisinin resistance has been found in five countries in
Southeast Asia - Cambodia, Laos, Myanmar, Thailand and Vietnam. Resistance to both artemisinin and drugs used in combination
with it has developed in parts of Cambodia and Thailand.
Experts are particularly concerned that artemisinin
resistance will spread to sub-Saharan Africa where about 90 percent of malaria
cases and deaths occur.
"Because few other artemisinin combination therapies
are available, and because artemisinin resistance will probably accelerate
resistance to any partner drug, investigations of alternative treatment
approaches are urgently needed," the researchers said. They suggest an alternative treatment should be tested,
comprising artesunate, a form of artemisinin, combined with mefloquine, a
different long-acting partner drug. "The intensive spread of artemisinin resistance in
Cambodia is rapidly threatening to reduce the efficacy of all artemisinin
combination therapies used in this country and in bordering areas of Vietnam,
Laos, and Thailand," the article said.
Malaria patients in areas with drug-resistant malaria should
be treated in hospital, the researchers said, "... intensified efforts are
needed to discourage what appears to be a highly ineffective approach of
self-treatment in the private sector."
The research was produced by the U.S. National Institute of
Allergy and Infectious Diseases.
About 3.2 billion people - almost half the world's
population - are at risk of malaria, according to the World Health
Organization.
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