New hope for people infected with severe malaria

Quinine, one the world's oldest malaria drugs, comes from the cinchona plant Copyright: Wikipedia

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Researchers have found long-awaited proof that a drug derived from a Chinese plant fights severe malaria far more effectively than older treatments.

A team led by Nick White at Thailand’s Mahidol University studied nearly 1,500 malaria patients in Bangladesh, India, Indonesia and Myanmar. They showed that the drug — artesunate — saved one-third more lives than quinine did.

The researchers, whose findings are published in The Lancet today (26 August), say this means artesunate should soon be available wherever malaria is a major problem. 

Artesunate belongs to a class of drugs called artemisinins, derived a shrub called sweet wormwood. 

In 2001, the World Health Organization (WHO) recommended using drugs containing artemisinins to treat ‘uncomplicated’ malaria caused by the Plasmodium falciparum parasite.

But no one had proved the benefit of artemisinins for treating malaria. One to two per cent of infected people go on to develop severe malaria, and it can kill one in three even after treatment.

Several research groups had tested an artemisinin derivative called arthemeter, but this seemed to be no better than quinine.

Researchers’ attention then switched to artesunate, another type of artemisinin, when early tests suggested it could be effective against severe malaria.

White’s team say they have provided the evidence needed to warrant using artesunate in adults worldwide.

But they note that the same findings might not apply to children in Africa, in whom severe malaria develops in a different way.

Other scientists have just begun a similar trial. White’s team says this should offer more answers about how to deal with severe malaria in Africa, where the disease kills one child every 30 seconds.

Link to full paper in The Lancet*

Reference: Lancet 366, 717 (2005)

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