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Partner-drug resistance accelerates resistance of first-line malaria drug

Partner-drug resistance accelerates resistance of first-line malaria drug
A woman from Cte d’Ivoire receives a malaria test. Based on the World Health Organization, in 2020, malaria caused around 241 million clinical episodes and 627,000 deaths. Credit: Dan Lesher, Penn State

The drug artemisinin may be the world’s most significant first-line drug for the treating malaria, an illness spread by mosquitoes that has been in charge of 627,000 deaths globally in 2020. To avoid the malaria parasite (Plasmodium falciparum) from evolving resistance to artemisinin, the planet Health Organization has recommended, since 2005, that partner drugs get alongside artemisinin. Yet, the parasite has recently become resistant to a number of these drugs. A fresh research collaboration between Penn State, Oxford and Imperial College London demonstrates that resistance to partner drugs facilitates resistance evolution to artemisinin.

“Drug-resistance surveillance efforts have been recently centered on understanding the emergence and spread of -resistance in Plasmodium falciparum,” said Maciej Boni, associate professor of biology. “Our results show that focusing surveillance on partner-drug resistance can be had a need to slow the spread of artemisinin resistance.”

The team, which comprised a consortium of modeling groups, used multiple mathematical models to forecast the evolution of artemisinin resistance under a variety of epidemiological settings. Specifically, the models examined different degrees of malaria prevalence and pre-existing partner-drug resistance, along with varying examples of usage of antimalarial combination therapies, including dihydroartemisinin-piperaquine, artesunate-amodiaquine and artemether-lumefantrine.

The team discovered that the current presence of higher frequencies of partner-drug resistant Plasmodium falciparum genotypes resulted in earlier establishment of artemisinin resistance among these parasites. Across all models, a 10-fold upsurge in the frequency of partner-drug resistant Plasmodium falciparum normally corresponded to a lack of artemisinin efficacy 2-12 years sooner than it could have if the partner drugs were acting at full efficacy. Of the three drug combinations, dihydroartemisininpiperaquine was most vunerable to the procedure of partner-drug resistance accelerating the evolution of artemisinin resistance. Notably, the team observed substantial reductions in the establishment time for artemisinin resistance even at lower partner-drug resistance frequencies.

The findings published Aug. 2 in the journal The Lancet Microbe.

“Our findings indicate that early surveillance for partner-drug resistance is essential to avoid the spread of artemisinin resistance, as even low frequencies of partner-drug resistance can facilitate the first emergence of artemisinin resistance,” said Boni. “Although public health concern typically arises only after partner-drug resistance is common, our study shows that early detection of and pre-emptive action against partner-drug resistance could have the advantage of delaying partner-drug resistance, artemisinin resistance and treatment failure, all at one time.”

More info: Oliver J Watson et al, Pre-existing partner-drug resistance to artemisinin combination therapies facilitates the emergence and spread of artemisinin resistance: a consensus modelling study, The Lancet Microbe (2022). DOI: 10.1016/S2666-5247(22)00155-0

Citation: Partner-drug resistance accelerates resistance of first-line malaria drug (2022, August 29) retrieved 29 August 2022 from

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