A study today in the New England Journal of Medicine reports evidence of emerging artemisinin-resistant malaria in Uganda, a potentially worrisome development for Africa.
Conducted at a hospital in Northern Uganda, where malaria transmission is high, the study found that 5.8% of malaria patients treated with an artemisinin derivative from 2017 through 2019 had evidence of slow parasite clearance, which can be a sign of partial resistance to artemisinin. Further analysis of parasite DNA samples from patient blood samples identified genetic mutations associated with delayed parasite clearance and artemisinin resistance.
Artemisinin and artemisinin combination therapies (ACTs) are the most effective and widely used treatment for malaria caused by the Plasmodium falciparum parasite and have greatly contributed to global reductions in malaria deaths and complications. While artemisinin resistance is widespread in the Greater Mekong Subregion of Southeast Asia, experts fear it could have a devastating impact in Africa, where 90% of malaria cases and deaths are reported.
“Our findings suggest a potential risk of cross-border spread across Africa and highlight the need to perform large-scale surveys,” the team of researchers from Uganda and Japan wrote.