Drug resistant malaria rising in Asia

Positive malaria test result

New research has found that multi-drug resistant malaria is spreading in Asia.

Researchers at the Wellcome Sanger Institute and University of Oxford, both in the UK, and Mahidol University, Bangkok, discovered that in Vietnam, Laos and northeastern Thailand descendants of a multi-drug resistant malaria strain are replacing the local parasite populations. The research was published in The Lancet Infectious Disease.

The research represents the most up-to-date and comprehensive whole genome study of malaria parasites in Southeast Asia and has highlighted the importance of ongoing genomic surveillance to inform public health malaria control strategies.

The team sequenced and analysed the DNA of 1,673 Plasmodium falciparum parasites (those responsible for malaria), taken from the blood of malaria patients between 2008 and 2018. They found that the multi-drug resistant KEL1/PLA1 parasites had spread internationally, in some regions making up more than 80 per cent of the parasites analysed.

“We discovered that the multi-drug resistant KEL1/PLA1 malaria strain had spread aggressively, replacing local malaria parasites, and had become the dominant strain in Vietnam, Laos and northeastern Thailand. Our large-scale genomic approach demonstrates how surveillance can provide crucial information to malaria control programmes, supporting them in evaluating available treatment options,” stated the study’s first joint author, Dr Roberto Amato of the Wellcome Sanger Institute.

Professor Dominic Kwiatkowski, a senior author on the paper from the Wellcome Sanger Institute and the Big Data Institute at University of Oxford, also commented on the findings: “Our study provides a clear picture of how malaria that is resistant to the first-line treatment is spreading, and demonstrates the importance of using genetics to detect patterns of resistance in each area. Active genomic surveillance is now vital to inform national malaria control programmes, to help reduce the risk of a major global outbreak.”