By: Wagdy Sawahel
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Malaria parasites found in West Africa are showing signs of resistance to what is thought to be the most powerful antimalarial drug, say researchers.
Artemisinin was introduced in several African countries after the parasite developed resistance to chloroquine, previously one of the most common drugs.
Yet, in The Lancet this week (3 December), a team of researchers from Cambodia, France and Senegal show that some resistance to the drug is emerging in French Guiana and Senegal.
Ronan Jambou, who led the project at the Pasteur Institute in Dakar, Senegal, says that "for the moment we can expect no impact on the treatment of malaria in Africa" because artemisinin is administered not in isolation but only in combination with other antimalarial drugs.
Researchers believe the parasite is less likely to develop resistance to a combination of drugs than to a single drug used in isolation.
He adds, however, that the parasite’s resistance to artemisinin should be carefully monitored to avoid a repetition of what happened with chloroquine.
The team took blood samples from 530 malaria patients in Cambodia, French Guiana and Senegal, and tested the parasites to see if they were resistant to artemisinin.
In response to the widespread emergence of malaria parasite strains that are resistant to several drugs, the World Health Organization (WHO) has recommended the use of artemisinin-based combination drug therapy as first-line treatment.
"Jambou and colleague’s paper is a wake-up call," write US researchers Patrick Duffy and Carol Sibley in a comment published with the report.
"We ignore this warning at the risk of a rapid demise of ACTs that are currently just being tested and deployed," they add.
Link to full paper by R. Jambou et al. in The Lancet
[available from 5 December]
Link to full commentary by P. Duffy and C. Sibley in The Lancet
[available from 5 December]
Reference: The Lancet 366, 1908 (2005)