Drug Resistance in Malaria 2020 Report | UPSC
Antimalaria drug resistance not alarming but growing fast, says WHO report
WHY IN NEWS:
Three states in India’s North East reported resistance to commonly used drug against malaria
SYLLABUS COVERED: GS 3: Reports : Diseases
For PRELIMS go through the parasites and treatment . Make a chart if possible .
For MAINS note down all the potential causes of increasing drug resistance and instances throughout the globe.
- Fight against this killer is becoming difficult due to the growing resistance against malarial drugs.
- Risk due to antimalarial drug resistance is not high currently, but can lead to a loss of hard-fought gains,
- According to the new WHO report, ACTs remain efficacious across the world, by and large.
- This parasite causes a majority of malarial cases in the WHO’s African and South-East Asian regions, the hubs of the disease.
- Wherever treatment failures were observed, policy changes were introduced.
- The five countries in the Greater Mekong Subregion (GMS) including Cambodia, Laos, Vietnam, Thailand and Myanmar have been epicentres of antimalarial drug resistance.
- Drug resistance in malaria
- World Health Organisation (WHO)
- The report, released as part of the ongoing World Antimicrobial Awareness week, was prepared on the basis of studies conducted from 2010-2019.
- 1,046 studies conducted from 2010-2019 and involving 65,749 patients was analysed for preparing the report.
- The report says that some ACTs combinations are no more efficacious in the above mentioned epicentre countries.
- However, the saving grace is that not all ACTs are ineffective yet and at least two are still working.
- The mutations in the malarial parasite have been responsible for artemisinin partial resistance.
- As many as 1,044 studies conducted globally from 2010-2019 confirmed the PfK13 mutation.
- The highest prevalence of PfK13 mutations was found in the GMS.
- ‘C580Y’ is the mutation most frequently identified.
OTHER MALARIA PARASITE
- The other common parasite that causes malaria, especially in India, is P vivax.
- P vivax resistance to chloroquine had been reported from all WHO regions.
- Antimalarial therapies other than CQ had been deployed to treat malaria cases and they had shown effective results.
DISEASE INCIDENCE AND TRENDS
- Malaria occurs in over 90 countries worldwide.
- Each year an estimated 300 to 500 million clinical cases of malaria occur.
- This makes malaria one of the most common infectious diseases worldwide.
- Malaria transmission occurs primarily in tropical and subtropical regions in sub-Saharan Africa, Central and South America.
- The disease is also prevalent in the Middle East, the Indian subcontinent, South-East Asia, and Oceania.
- In humans, malaria infection is caused by one or more of four species of intracellular protozoan parasite.
- Simple light microscopic examination of Giemsastained blood films is the most widely practised
- A second method is a modification of light microscopy called the quantitative buffy coat method is also used.
CURRENT STATUS OF DRUG-RESISTANT MALARIA
- Resistance to antimalarial drugs has been described for two of the four species of malaria parasite that naturally infect humans.
- Although the geographical distribution of resistance to any single antimalarial drug varies greatly.
FACTORS CONTRIBUTING TO THE SPREAD OF RESISTANCE
- Disparate issues as human behaviour
- Vector and parasite biology
- Pharmacokinetics, and economics.
- Conditions leading to malaria treatment failure .
- Drug resistance is not an all-or-nothing phenomenon, chloroquine still retains adequate efficacy.
- The report noted – Tripura, Arunachal Pradesh and Mizoram had shown that the parasite had become resistant ‘artesunate and sulfadoxine-pyrimethamine (AS+SP) combination’.
- These states have shifted to using artemether-lumefantrine .
- All other states which show resistance to the AS+SP combination will have to make this move.
- In India, 28 different mutations had been detected in the studies conducted in the last ten years.
- A widespread resistance scenario could emerge on the basis of a study of hypothetical scenarios .
- This would result in a yearly excess of 22 million treatment failures, 116,000 deaths .
- The costs include an estimated $130 million to change treatment policy.
- Imperfect coverage of antimalarial drugs, improper diagnosis, misuse of drugs and not-so-good mosquito control programmes were cited by the report.
- We should support new drug development. Investigate new approaches to drug delivery.
- Up-to-date, quality data are needed on the efficacy of the recommended treatments, to ensure that patients receive efficacious treatment.
- Investigation should happen how a combination therapy strategy could be financed.
- Last but not the least, We need to improve access to and use of definitive diagnosis-based treatment.
SOURCES: DownToEarth | Drug Resistance in Malaria 2020 Report | UPSC