Study finds gene markers
for drug-resistant malaria in Cambodia
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[November 04, 2016]
By Kate Kelland
LONDON (Reuters) - Scientists have
discovered genetic markers in malaria parasites linked to resistance to
the key anti-malarial medicine piperaquine, and say their work could
help doctors and health officials monitor and limit the spread of such
resistance.
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In research published in the Lancet Infectious Diseases journal, the
team also said a simple test using blood taken from a finger
pinprick could show whether a malaria patient has parasites with the
genetic markers - allowing doctors to prescribe an alternative
treatment.
Resistance to piperaquine recently emerged in Cambodia and has led
to the complete failure of malaria treatment there. This and other
spreading areas of drug-resistance are threatening global efforts to
eliminate the mosquito-borne disease.
Piperaquine is a powerful drug which is used in many parts of the
world in combination with another anti-malarial drug called
artemisinin.
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Resistance to artemisinin emerged around seven years ago in
Southeast Asia, but until recently the combination of the two drugs
had successfully killed the malaria parasites there. Now, however,
the emergence of piperaquine resistance in Cambodia has led to
treatment failing altogether.
"These malaria parasites are now resistant to both drugs, and since
they are no longer being killed, resistance to both drugs will
spread," said Roberto Amato, who co-led the research at Britain's
Sanger Institute.
According to the World Health Organization, an estimated 200 million
people worldwide were infected with malaria in 2015, and nearly half
a million people died from the disease. The vast majority of those
killed by it are children under five.
Malaria is treatable if it is caught early, but growing drug
resistance is becoming a major problem in many areas.
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For this study, Amato's team worked with Rick Fairhurst, a professor
at the National Institute of Allergy and Infectious Diseases at the
United States National Institute of Health, and carried out what is
known as a genome-wide association study to look at the genetic
basis behind piperaquine resistance.
They looked at around 300 samples from Cambodia, analyzing thousands
of variations in the DNA sequence of the parasites and comparing
these across samples with different levels of resistance to
piperaquine.
"By studying the genomes of these parasites we found two genetic
markers that are linked with piperaquine resistance," Amato said.
"Not only can we now use these markers to monitor the spread of the
drug resistant malaria, they will also help towards understanding as
much as possible about the biology and evolution of the (malaria)
parasite."
(Editing by Mark Heinrich)
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