A child suffering from malaria lies on the floor of a crowded hospital in Amuria, Uganda, East AfricaCREDIT: Jake Lyell / Alamy Stock Photo
Resistance to the lifesaving malaria drug, artemisinin, may be emerging in young African children with serious infections, a study from patients in a Ugandan hospital has revealed.
The study1 by researchers from Kenya, Uganda, the United Kingdom and the United States, published in the Journal of the American Medical Association (JAMA), observed partial resistance to artemisinin in 11 of 100 children, aged 6 months to 12 years, who were undergoing complicated malaria treatment-malaria with signs of severe disease caused by the malaria parasite Plasmodium falciparum.
“Complicated” malaria has signs of severe disease, evidence of organ dysfunction like anemia, cerebral malaria, acute kidney injury, and repeated seizures, says John Chandy, the study’s co-author from Indiana University School of Medicine, Indianapolis. All children in the study were admitted to the hospital for care of their severe disease. The researchers found that 11 patients, who were thought to have been cured suffered a repeat malaria attack within 28 days. This was from the same strain that caused the original infection, suggesting that the initial treatment did not fully kill the infecting parasites.
According to the study, artmesinin's efficacy potential is dwindling, a dire prospect, especially for African children under five years, who account for 95% of the 608,000 people who die from malaria annually.
While all the studied children eventually recovered, 10 of them were infected with malaria parasites that harbour mutations linked to artemisinin-resistance in Southeast Asia, where resistant malaria parasites emerged with evidence of partial artemisinin resistance.
“The current recommendation is to prolong therapy until parasites on the blood smear are cleared and then complete the full oral follow-up treatment for severe malaria,” Chandy tells Nature Africa.
