A day after eight out of 54 African countries on Jan 30 launched a new platform, End Malaria Council with a commitment to eradicate malaria from their countries, UK doctors have alerted the Continent leaders on the looming danger ahead following the failure of a key malaria treatment for the first time in patients being treated in the UK.
The patients had caught malaria while visiting Africa
The Council includes Equatorial Guinea, Guinea, Eritrea, Ethiopia, Gabon, Ghana, Guinea and Kenya and high-level private sector leaders.
The UK doctors fear the failure is an early signs the parasite is evolving resistance.
Though a team at the London School of Hygiene and Tropical Medicine said it was too early to panic, they however warned things could suddenly get worse and demanded an urgent appraisal of drug-resistance levels in Africa.
Malaria is a major killer of the under-fives with one child dying from the disease every two minutes in African countries.
Between 1,500 and 2,000 people are treated for malaria in the UK each year – always after foreign travel.
Most are treated with the combination drug: artemether-lumefantrine.
But clinical reports, now detailed in the journal Antimicrobial Agents and Chemotherapy, showed the therapy failed in four patients between October 2015 and February 2016.
All initially responded to therapy and were sent home, but were readmitted around a month later when the infection rebounded.
Samples of the parasite that causes malaria were analysed at the Malaria Reference Laboratory at the London School of Hygiene and Tropical Medicine.
Dr Colin Sutherland said: “It’s remarkable there’s been four apparent failures of treatment, there’s not been any other published account [in the UK].”
All of the patients were eventually treated using other therapies.
But the detailed analysis of the parasites suggested they were developing ways of resisting the effects of the front-line drugs.
Dr Sutherland added: “It does feel like something is changing, but we’re not yet in a crisis.
“It is an early sign and we need to take it quite seriously as it may be snowballing into something with greater impact.”
Two of the cases were associated with travel to Uganda, one with Angola and one with Liberia – suggesting drug-resistant malaria could be emerging over wide regions of the continent.
Dr Sutherland added: “There has been anecdotal evidence in Africa of treatment failure on a scale that is clinically challenging.
“We need to go in and look carefully at drug efficacy.”
The malaria parasites all seemed to be evolving different mechanisms rather than they’re being one new type of resistant malaria parasite spreading through the continent.
The type of resistance is also clearly distinct from the form developing in South East Asia that has been been causing huge international concern
Dr Sutherland says doctors in the UK need to be aware the drugs might not work and argued current treatment guidelines may need to be reviewed.
Professor David Lalloo, Dean of Clinical Sciences and International Public Health at Liverpool School of Tropical Medicine, said more studies are needed.
“This is an interesting and well conducted study and again emphasizes the incredible ability of the malaria parasite to rapidly evolve to become resistant to antimalarial treatment,” he said.
“It is too early to fully evaluate the significance of these findings but the paper highlights the need to be constantly vigilant when treating patients with malaria and larger studies are certainly needed to explore this issue further.” With additional reports from BBC