topnaman | Malaria blog

The world-wide antimalarial resistance network (WWARN) is a great idea. The concept is simple: drug-resistant strains spread and a bigger picture is needed – consolidate data from existing monitoring efforts and standardize protocols to ensure comparability. A series of articles in 2009, published in Malaria Journal, outlined the rationale and a plan for creating a global [...]

The NY Times featured artemisinin resistance along the Thai-Cambodia border yesterday (though it wasn’t written by Donald McNeil who is the author for most of their global health work). I’ve previously discussed the topic (here, and here), and I am part of a team which researches malaria drug resistance in Cambodia. First, my use of [...]

Millions of people get treated for malaria every year so its important to use an antimalarial which works. Treatment failures result in a prolonged illness for the patient with an increased risk of severe malaria and death. In addition, they contribute to increased malaria transmission. Makes sense right? However, the parasite has an amazing ability [...]

Bate et al. tested antimalarial quality for several drugs in 6 countries across sub-Saharan Africa and found an alarming 35% were substandard as gauged by thin layer chromatography or dissolution tests. The authors did not attempt to assess whether counterfeit or not as the outcome would remain the same – i.e. the drugs are substandard [...]

In early April of this year a Vietnamese news source carried an article about the challenges of malaria control and the possibility of future malaria epidemics. A substantial portion of the piece focused on antimalarial resistance, including high failure rates of chloroquine and sulphadoxine-pyrimethamine. What was surprising was a passing mention of artesunate failures:
… while [...]

Artemisinin combination therapies (ACTs) have become the global standard for the treatment of Plasmodium falciparum malaria in areas with existing or emerging drug resistance. ACTs have several advantages: combination therapy diminishes the probability of de novo mutation, artemisinin is the most schizonticidal drug and reduces parasite biomass very rapidly resulting in faster clearance rates, and [...]

GlaxoSmithKline pulled Lapdap (chloroproguanil-dapsone) from the market and ended the development of Dacart (Lapdap+artesunate) after phase III trials of the drugs showed significant hemoglobin reductions in patients with glucose 6-phosphate dehydrogenase (G6PD) deficiency. Patient’s with G6PD deficiency have weaker red blood cell membranes which can rupture when exposed to oxidative stress caused by certain drugs [...]

Much of the world still diagnoses malaria clinically (based on symptoms alone without testing for the presence of the parasite). Recently, a Liverpool team working in Mozambique examined the cost to individual patients resulting from the clinical diagnosis of malaria (Malaria Journal – open access). The findings were striking but certainly not surprising. 23 percent [...]