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First recorded cases of frontline malaria drug failing to treat UK patients
For the first time, cases of resistance to anti-malaria drugs have been reported in the UK. The London School of Hygiene & Tropical Medicine has reported that four cases of resistance to the anti-malaria drug artemether-lumefantrine, a type of Artemisinin Combination Therapy (ACT), were observed in UK hospitals in a short period of time; between October 2015 and February 2016.
The World Health Organization recommends ACTs as the first-line treatment for uncomplicated Plasmodium falciparum malaria. Importantly, these are among the very first well-described cases of reduced susceptibility to ACT drugs used in Africa, an area of the world where most malaria cases and deaths occur.
The four patients, who all recovered after receiving alternative treatment, were admitted to hospital after returning from Angola, Liberia or Uganda. Following initial treatment, all the patients recovered and were discharged following near complete clearance of the Plasmodium falciparum parasites. However, within six weeks of treatment each patient was readmitted with recurrent symptoms and increased levels of parasites in their blood.
Dr Colin Sutherland, Reader in Parasitology at the London School of Hygiene & Tropical Medicine who led the study, said: “These cases act as a warning for Africa. Drug resistance is one of the biggest threats we face in fighting malaria, and is already starting to occur in parasite strains prevalent in parts of South-East Asia.”
Following the publication Professor Dame Sally Davies, Chief Medical Officer of the UK has responded:
“This is a stark warning for the future of global medicine. While it is an isolated incident, this type of case continues to be more frequent across the world.
We are in dire need of new drugs to keep pace with resistance. We need to stimulate the pharmaceutical, diagnostic and research sectors to focus on new drugs that have the biggest public good.”
Colin J. Sutherland, Paul Lansdell, Mandy Sanders, Julian Muwanguzi, Donelly A. van Schalkwyk, Harparkash Kaur, Debbie Nolder, Julie Tucker, Hayley M. Bennett, Thomas D. Otto, Matthew Berriman, Trupti A. Patel, Roderick Lynn, Effrossyni Gkrania-Klotsas, Peter L. Chiodini. Pfk13-independent treatment failure in four imported cases of Plasmodium falciparum malaria given artemether-lumefantrine in the UK. Antimicrobial Agents and Chemotherapy. DOI:10.1128/AAC.02382-16 - http://aac.asm.org/content/early/2017/01/05/AAC.02382-16.abstract
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