Malaria drug becoming less effective in young African children

Researchers have found “disturbing” evidence for the first time that a lifesaving malaria drug is becoming less effective in young African children with serious infections.

Researchers from the Indiana University School of Medicine in collaboration with counterparts at Makerere University in Uganda uncovered evidence of partial resistance to artemisinin derivatives the primary treatment for malaria in young children with severe, or ‘complicated,’ malaria.

The study of children being treated in a hospital for malaria in Uganda found signs of resistance to artemisinin in one patient in ten.

Earlier studies have shown partial resistance to artemisinin in children with uncomplicated malaria, but the new study, published in the Journal of the American Medical Association (JAMA), is the first to document such resistance in African children with well-defined signs of severe disease from malaria.

Dr Chandy John, of Indiana University, who co-wrote the study with international colleagues, said: “This is the first study from Africa showing that children with malaria and clear signs of severe disease are experiencing at least partial resistance to artemisinin.”

A further ten of the children studied, who were thought to have been cured of infection, suffered a repeat attack from the same strain of malaria within a month. The results suggest that the “gold-standard” treatment they had received, combining artemisinin with a second malaria drug called lumefantrine, was not working as well as it should.

John said the study was started after researchers noticed a slow response to treatment in some children who were already being monitored for a project on severe malaria in young patients

He noted that “Artemisinin-based therapies have been quintessential in the fight against malaria for the past 20 years.

According to him, growing evidence of artemisinin partial resistance in African children with uncomplicated malaria has led to concerns that new therapies, like triple artemisinin combination therapies, may be needed in uncomplicated malaria.

“The findings of artemisinin partial resistance in children with severe or complicated malaria.”