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African malaria parasite develops resistance against first-line drug

Malaria kills nearly 500,000 people every year, the vast majority of which are young children living in Africa. Malaria parasite resistance to the most widely used and effective drug, artemisinin, has been reported from parts of Southeast Asia, where efforts are continuing to contain its spread.

New research now shows that African malaria parasites have developed tolerance to the drug. The new report, led by Professor Jun Cao of Jiangsu Institute of Parasitic Diseases, and involving researchers from Saudi Arabia's King Abdullah University of Science and Technology and the Malaria Unit at Nagasaki University, Japan, describes the failure of artemisinin to cure a malaria infection in a Chinese migrant worker living in Equatorial Guinea. Subsequent testing of the parasite showed that it was less sensitive to artemisinin than other African malaria parasites, and that it carried a unique mutation in a gene known to be involved in resistance against the drug. The parasite was shown to be of local, African, origin, and was not imported from outside the continent. The work is published in the prestigious New England Journal of Medicine this month.

The possible implications of this finding are enormous, with the whole of Africa reliant on artemisinin for malaria control and elimination, any lessening of its effectiveness could lead to a public health disaster on the continent. This work will help in the monitoring of the emergence and spread of drug-resistant malaria and may help avert a malaria crisis in Africa.

PAPER TITLE: Emergence of Indigenous Artemisinin Resistant Plasmodium falciparum in Africa
JOURNAL: New England Journal of Medicine