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Resistant Strain of Malaria Spreads Across Myanmar, Nears India

A government health worker takes a blood sample from a woman to be tested for malaria in Ta Gay Laung village hall in Hpa-An district in Kayin state, southeastern Myanmar, Nov. 28, 2014.
A government health worker takes a blood sample from a woman to be tested for malaria in Ta Gay Laung village hall in Hpa-An district in Kayin state, southeastern Myanmar, Nov. 28, 2014.

A strain of malaria resistant to the most effective current treatment has spread across Myanmar and has nearly reached the Indian border, a study published Friday says.

The senior author, Charles Woodrow of the Mahidol-Oxford Tropical Medicine Research Unit in Bangkok, said researchers had confirmed the presence of resistant parasites at Homalin, Sagaing Region, just 25 kilometers from India.

“To see the levels of resistant parasites that we do extending that far sort of north [in Myanmar] and close to the border was, to some degree, a surprise,” Woodrow said.

“We don't know exactly how fast things are moving," he added. "Our study is a snapshot, really, as to the current situation. It's reasonable to say that, yes, we should be worried about movement of people and parasites over relatively short distances and that being a process which would lead for this process to spread further.”

Researchers fear the parasites will follow the trajectory of previous drug-resistant strains that eventually migrated all the way to Africa, ruining the current opportunity to eradicate malaria.

Starts with mosquito bite

Humans get the infectious disease when a mosquito's bite injects a parasite into the bloodstream. That transports the invader into the liver, where the parasite breeds.

A drug known as artemisinin is a key component of the most successful contemporary treatment for malaria in humans caused by the parasite, plasmodium falciparum.

The study, published in the medical journal Lancet Infectious Diseases, is the result of field research conducted by Myanmar's Defense Service Medical Research Center.

Researchers examined whether the parasites from different areas of Myanmar, also known as Burma, carried mutations in a marker gene of the parasite. A total of 940 parasite samples were collected from patients at 55 malaria treatment centers across the country.

Myanmar is considered the gateway for the artemisinin-resistant strain to spread to the rest of the world.

Isolated from the sweet wormwood plant, artemisinin and its derivatives have been able to swiftly reduce the number of plasmodium parasites in the blood of malaria patients.

The parasite resistant to the drug — considered the last line of defense against malaria — is present in parts of four other Southeast Asian countries besides Myanmar: Cambodia, Laos, Thailand and Vietnam. So far, however, the infection has been a problem limited to natural forest areas, not the big cities in low-lying deltas.

Treatment options shrinking

If malaria patients in Southeast Asia are given an appropriate combination of drugs, “they should still be cured in more than 95 percent of cases. But the number of options for that is shrinking,” Woodrow said. “When you have artemisinin resistance, you are beginning to erode your margin of error and you start to burn through these partner drugs relatively quickly.”

This is especially true in parts of Cambodia, public health officials said.

Earlier this month, the executive secretary of the Asia Pacific Leaders Malaria Alliance told VOA News that options were running out in the race to eliminate malaria before the parasite responsible for the deadly disease outsmarts artemisinin.

“There are very few options and indeed there are very few drugs in the pipeline. So, really, we have one shot at eliminating this disease," said APLMA's Benjamin Rolfe. "If we don’t eliminate it in the next 15 years, we will lose our tools, lose our armory, and we are very likely, indeed almost certain, to see a resurgence of this disease in the Asia-Pacific region and then, subsequently, in the African region.”

Rolfe warned that “if resistance spreads through India to Africa, we risk seeing many millions of deaths.”

Malaria infects about 200 million people annually. In 2013, the latest year for which data are available, it caused an estimated 584 000 deaths, the World Health Organization said.