Drug Resistant Mutated Malaria Spreading Through Asia

Parasites resistant to the frontline malaria drug have spread westward from south-east Asia to just short of the Indian border, a gateway to Africa, researchers warned on Friday.

A spread into India "would pose a serious threat to the global control and eradication of malaria," said a media statement.

"If drug resistance spreads from Asia to the African sub-continent, or emerges in Africa independently as we've seen several times before, millions of lives will be at risk."

Since the Plasmodium parasite developed resistance to other drug types, Artemisinin is the best and safest medicine to treat the estimated 198 million malaria infections that occurred worldwide in 2013.

There were about 584,000 deaths, according to the UN's World Health Organization (WHO) 90 percent of them in Africa.

Artemisinin resistance has not yet been detected in Africa, but is a growing problem in southeast Asian nations like Cambodia, Thailand and Vietnam, and is suspected, though not proven, to have taken hold in South America.

Myanmar, which carries the region's highest malaria burden, is considered the parasite's main route from south-east Asia to India and beyond.

For the study, researchers collected samples from patients at 55 treatment centres across Myanmar and border regions of Thailand and Bangladesh in 2013 and 2014, and examined them for telltale mutations in the K13 or "kelch" gene.

Thirty-nine percent of 940 malaria samples carried a mutation, they found.  The team then used the data to produce a map of estimated regional prevalence, and predicted resistance as far west as Homalin in Myanmar 25 kilometres from the frontier with India.

The malaria parasite is transmitted via the bites of infected mosquitoes. It multiplies in the human liver and infects red blood cells, and can be deadly if untreated. There have been two examples in history of malaria drugs becoming less effective due to the emergence of resistance costing millions of lives.

From the 1950s to 1970s, chloroquine-resistant parasites spread from Asia to Africa. Chloroquine was replaced by sulphadoxine-pyrimethamine (SP), resistance to which emerged in western Cambodia and spread to Africa. SP was then followed by Artemisinin, a drug derived by Chinese scientists from a herb called sweet wormwood.