Taane Clark and colleagues from the London School of Hygiene and Tropical Medicine (LSHTM) stated that new mutations of the parasite that causes malaria enhances resistance to a drug used to prevent malaria in pregnant women and children. It is already common in countries fighting the disease. PLOS Genetics published the latest results on December 31.
Malaria causes about 435,000 mortalities every year, primarily in young children in sub-Saharan Africa. Despite a long-term global response, the rise of drug-resistant strains of the parasite species that cause malaria hampers the disease’s control efforts. For example, Sulfadoxine-pyrimethamine (SP) was once a first-line anti-malarial treatment, but now principally is used to prevent infection in children and pregnant women. Sulfadoxine-pyrimethamine (SP) was utilized globally as a first-line treatment for malaria after wide-spread resistance to chloroquine emerged. Mutations in the parasite Plasmodium falciparum’s two genes extend resistance to SP, but recently, the study discovered the mutations associated with resistance in a third gene, pfgch1. To understand the extent and spread of these new mutations, Clark and colleagues analyzed genome sequences from 4,134 blood samples collected from 29 countries where malaria is endemic. They discovered at least ten different versions of pfgch1, occurring in about one-quarter and in one-third of the specimen samples from Southeast Asia and Africa, respectively, where strains carrying the mutations may be on the rise.
The increase in the number of malaria parasites with pfgch1 mutations needs concern because these can intensify resistance to SP and may promote the evolution of new resistant strains. Due to this, their growth may threaten efforts to use SP to prevent malaria in vulnerable groups. By identifying these pfgch1 mutations through the new study, scientists can monitor their presence in parasite populations to understand where to use SP effectively and where drug-resistance rates are already too high.
“It is desirable to learn how these mutations function and monitor them as part of malaria surveillance programs,” says Clark.
Colin Sutherland, an author & co-Director of the LSHTM Malaria Centre, says, “SP is an authorized drug for malaria prevention and treating vulnerable groups such as children and pregnant women. We may have underestimated its vulnerability to parasite resistance, as these new data show.”
The rising prevalence of multidrug-resistant malaria is occurring at an alarming rate and has severe consequences for the health of many of the world’s poorest countries. The perils of not changing treatment practices immediately are vast and irreversible, threatening to exacerbate the malaria pandemic’s scale and scope and deprive policymakers of future options against the disease. If we want to avoid a health care disaster, massive and long-term funding is urgently required. Funds application in a cohesive manner is necessary. It should be accountable to funding bodies and tailored to each endemic region’s specifics. Such methodology’s key elements should be improving early diagnosis and treatment of infection and combining combination regimens. These short-term measures will need to be supplemented by a longer-term strategy to encourage anti-malarial drug research and development.