Multi-resistant parasites cause first-line medications
According to the work, in the 2016-2018 period malaria parasites resistant to both artemisinin and piperaquine, a widely used drug, accounted for more than 80% of those circulating in northeastern Thailand and Vietnam.
These parasites, which spread rapidly, have also acquired new resistance mutations related to even higher rates of treatment failure. This has caused failures in one of the newest and most potent first-line drug combinations (dihydroartemisinin-piperaquine) in half of the cases in western and northeastern Cambodia, northeastern Thailand and southwest Vietnam in 2015- 2018, further compromising efforts to eliminate the disease.
“These disturbing findings indicate that the problem of resistance to multiple medications in P. falciparum has worsened substantially in Southeast Asia since 2015. This successful strain resistant to parasites is capable of invading new territories and acquiring new genetic properties, which increases the frightening prospect that it could spread to Africa where most cases of malaria occur, as did chloroquine resistance in the 1980s, contributing to millions of deaths, “experts said.
Since it now provides an “ineffective” treatment and promotes the dissemination of resistance, the authors have requested that this commonly used first-line combination therapy be abandoned in the
“With the spread and intensification of resistance, our findings highlight the urgent need to adopt alternative first-line treatments. One option is to change the drug associated with piperaquine to a currently effective medication such as mefloquine or pironaridine, as they did. Cambodia and Thailand, “experts say, pointing out that there is a possibility that in the presence of artemisin resistance, these associated medications could also develop rapidly. “Another option is to use the triple ACT, in which artemisinin is combined with two associated medications instead of one,” scientists have assessed.