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Drug resistant malaria found

3rd August 2009

Researchers in Cambodia have warned that a new form of drug-resistant malaria could wipe out the world's main front-line defences against the killer disease.

Scientists in the western provinve of Pailin say the malaria parasite, which is carried by mosquitoes, is now showing signs of resistance to artemisinin, a highly effective cure based on an ancient remedy from traditional Chinese medicine.

Now, Cambodia is the testing ground for artemisinin-based therapies which until recently were hailed as the new wonder drug for malaria, which kills around one million people annually, most of them in the world's poorest countries.

Writing in the New England Journal of Medicine, researchers in Cambodia said that malaria patients in the province of Pailin in western Cambodia receiving artemisin-based drugs were taking far longer than normal to recover.

And a significant proportion were unable to rid their bodies of the malarial parasite, even after treatment.

Study leader Arjen Dondorp, who carried out the research for the World Health Organisation (WHO), said the research team carried out the first detailed analysis of artemisinin-resistance in the field.

Scientists compared how long it took to treat 40 malaria patients in Cambodia with a comparable set of patients in neighbouring northwest Thailand.

They concluded that malarial parasites in Cambodia were less affected by artemisinin than those in Thailand. Normally, artemisinin clears parasites from the body at an early stage in the disease, preventing them from maturing and reproducing.

However, the drug's action now appeared to have been impaired in Cambodia, the team said.

Artemisinin was rediscovered in China as a malaria treatment in the 1970s, and the Chinese gave it to their then allies, the Khmer Rouge. The length of use and relative lack of controls on medication in Cambodia may have contributed to the parasite's ability to develop resistance.

Used for centuries in Chinese medicine under the name qinghaosu, the drug was originally derived from the sweet wormwood tree, Artemisia annua.

Dondorp said his findings in Pailin were worrying, because instead of being able to kill the parasite in 48 hours artemisinin therapies now take about 84 hours.


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