Aizawl, lunglei, kolasib, mamit, lawngtlai, champhai, saiha, and serchhip fig. For cambodia, the birthplace of drugresistant malaria, the target date for p. Use cases for genetic epidemiology in malaria elimination. Symptoms usually begin ten to fifteen days after being bitten by an infected mosquito. However, data for 2015 to 2017 reflect that no substantial progress was made during this period. In the late 1950s chloroquine resistance to plasmodium falciparum occurred in south america and on the indochina subcontinent. The efficacy of the infusions has been ascribed to the sesquiterpene lactone, artemisinin. By the late 1980s, resistance to sulfadoxinepyrimethamine and to mefloquine was also prevalent on the thaicambodian and thaimyanmar thai. Drug resistance has also played a significant role in the occurrence and severity of epidemics in some parts of the world. Epidemiology of drug resistant malaria in republic of congo. Wongsrichanalai c1, pickard al, wernsdorfer wh, meshnick sr. Epidemiology of drugresistant malaria in republic of. Epidemiology, drug resistance, and pathophysiology of. An estimated 91% of deaths in 2010 were in the african region, followed by 6% in.
The 6 countries of the greater mekong subregion continue to make significant gains in their battle to eliminate malaria by 2030. After emerging and circulating for several years within cambodia, the p falciparum kel1pla1 colineage diversified into multiple subgroups and acquired new genetic features, including novel crt mutations. It is estimated that death toll of malaria exceeds one million people each year, and the victims are primarily children under the age of five. Antimalarial drug resistance antimalarial drug resistance is not new. In the 1970s and 1980s, plasmodium falciparum the parasite species responsible for the most common and most deadly form of malaria developed widespread resistance to previous antimalarial medicines, such as chloroquine and sulfadoxinepyrimethamine sp. Hepatitis c formerly hepatitis nona nonb human immunodeficiency virus hiv infection. Protozoan plasmodium parasites are the causative agents of malaria, a deadly disease that continues to afflict hundreds of millions of people every year. Travelers who reject the advice to take prophylaxis, who choose a suboptimal drug regimen such as chloroquine in an area with chloroquineresistant p. A multidrugresistant colineage of plasmodium falciparum malaria. Infections with malaria parasites can be asymptomatic, with mild or severe symptoms, or fatal, depending on many factors such as parasite virulence and host immune status. Malaria is a major public health problem in subsaharan africa and plasmodium falciparum infection is a leading cause of morbidity and mortality inflicting a huge economic burden in countries where the disease is endemic. Antimalarial drug resistance may occur due to variations in the. Malaria chapter 4 2020 yellow book travelers health.
These findings highlight the urgent need for elimination of this increasingly drugresistant. Extensive drug resistance in malaria and tuberculosis. Epidemiology of drugresistant malaria request pdf researchgate. We assessed the likelihood of importation of drugresistant malaria into singapore and the impact on public health of its subsequent secondary spread in singapore. Are we headed for a new era of malaria drug resistance. A sevenyear surveillance of epidemiology of malaria reveals travel and gender are the key drivers of dispersion of drug resistant genotypes in kenya moureen maraka1, 2, hoseah m. The emergence of multidrug resistance, including resistance to artemisinin and partner drugs, is a public health concern threatening the sustainability of the ongoing. Hand, foot and mouth disease hfmd hansens disease leprosy hantavirus pulmonary syndrome. A robust surveillance system is required to monitor and help contain the resistance. This use case describes a method that identifies drug resistant parasites within an individual with high sensitivity and specificity, regardless of the presence of symptoms or treatment failure, in a high to very low prevalence. Epidemiology of malaria malaria control during mass. Malaria is a mosquitoborne infectious disease that affects humans and other animals. Prevalence of plasmodium falciparum antimalarial drug resistance.
One species of malaria parasite called plasmodium falciparum can cause particularly severe and lifethreatening forms of the disease. Malaria is an infectious disease caused by a microscopic parasite called plasmodium, which is transferred between humans by mosquitos. These subgroups have rapidly spread into neighbouring countries, suggesting enhanced fitness. Molecular epidemiology of drugresistant malaria in western kenya highlands. Artemisininbased combination therapy act is recommended to improve malaria treatment efficacy and limit drugresistant parasites selection in malaria endemic areas. Mathematical models for the transmission dynamics of drug sensitive and resistant strains can be a useful tool to help to understand the factors that influence the spread of drug resistance, and they can therefore help in the design of rational strategies for the control of drug resistance. Since then, chloroquine resistance has spread to nearly all areas of the world where falciparum malaria is transmitted. Molecular epidemiology of drugresistant malaria in western kenya highlands article pdf available in bmc infectious diseases 81. Pdf molecular epidemiology of drugresistant malaria in. In addition to first and secondline antimalarial drug treatments, adjunctive and supportive care measures e. Molecular epidemiology of antimalarial drug resistance. Full text epidemiology of plasmodium falciparum infection and drug. For many years, chloroquine cq was the drug of choice in treating both p.
However, an attempt is made here to cover the current malaria situation in the world, and recent results of applied research which have relevance to the epidemiology of malaria. Malaria control during mass population movements and natural disasters the first in the series, provides a basic overview of the state of knowledge of epidemiology of malaria and public health interventions and practices for controlling the disease in situations involving forced. Malaria sickens and kills people through several pathological mechanisms, understood to varying degrees. Recent declines in the clinical effectiveness of antimalarial drugs, including artemisininbased combination therapy, have prompted. Malariafree islands epidemiology of malaria drugresistant malaria is a rapidly spreading global health threat malaria is a public health problem today in more than 90 countries, inhabited by 2,400 million people 40% of the worlds population. Drug resistance in malaria and in tuberculosis tb are major global health problems. Pdf in congo, urgent efforts are needed to help with the revision of the national antimalarial drug policy.
The malaria situation has been worsening in angola, partly due to armed conflict until the recent past and drugresistant plasmodium. By the late 1980s, resistance to sulfadoxinepyrimethamine and to mefloquine was also prevalent on the thaicambodian and thaimyanmar thaiburmese borders, rendering them established multidrug resistant mdr areas. A sevenyear surveillance of epidemiology of malaria. Harmful algal blooms habs head lice pediculosis hemolytic uremic syndrome hus hepatitis a spanish version. Parentsguardians of febrile children were interviewed by a medical assistant on antimalarial drug use in the 2 weeks preceding the visit or 2week recall method. In severe cases it can cause yellow skin, seizures, coma, or death. Drug resistance in malaria is a vitally important public health concern.
Resistance against malaria drugs has been a battle since day one. This study established the role of travel and gender in dispersion of chloroquine resistant genotypes in malaria epidemic zones in kenya. Epidemiology of drug resistance in malaria sciencedirect. Given the spread of resistance to the major antimalarial drugs, the world health organization who has recommended the use of artemisinin. A combination of two or more classes of antimalarial drug with unrelated mechanisms of action. By the late 1980s, resistance to sulfadoxinepyrimethamine and to mefloquine was also prevalent on the thaicambodian and thaimyanmar thaiburmese borders, rendering them established multidrug. Evolution and expansion of multidrugresistant malaria in southeast. Epidemiology of drugresistant malaria author links open overlay panel dr chansuda wongsrichanalai epidemiologist a amy l pickard doctoral student b walther h wernsdorfer professor c steven r meshnick professor of epidemiology b. Molecular epidemiology of drugresistant malaria in. Prevention and treatment of malaria is more complex due to the emergence of drug resistance, pesticide resistant mosquito vectors, and large populations of infected people in many areas of the world.
Epidemiological models for the spread of antimalarial. Drug resistance has been implicated in the spread of malaria to new areas and reemergence of malaria in areas where the disease had been eradi cated. Though parasite mutations have been associated with resistance, other factors could influence the resistance. Evolution and expansion of multidrugresistant malaria in. Such resistance is a major factor in the increasing difficulty in controlling malaria, and important developments during this period are. The development of chloroquine as an antimalarial drug and the subsequent evolution of drugresistant plasmodium strains had major impacts on global public health in the 20th century. Soon after chloroquines international release in the late 1940s, parasites began to fight back, particularly in colombia, thailand, and cambodia, 2 which were subjected to mass chloroquine treatments, often at low doses that promoted the evolution of resistant parasites. However, currently in most endemic areas, parasites have developed resistance to this drug 21. The parasite density can be estimated by looking at a monolayer of red blood cells rbcs on the thin smear using the oil immersion objective at 100x.
Assessment of p falciparum antimalarial susceptibility. Use of such genetic information for the early detection of resistance foci and future monitoring of drugresistant malaria is a potentially useful epidemiological tool, in conjunction with the conventional invivo and invitro drugsensitivity assessments. The world health organization estimates that two billion people are at. The epidemiology of malaria cases in singapore was analysed. As a result of increasing drugresistant malaria, artemisinin from wormwood and semisynthetic derivatives of this substance have become a very important antimalarial drug group. The emergence and spread of antimalarial drug resistance are posing tremendous challenges for malaria. Amolo1, dennis juma2, duke omariba 2, agnes cheruiyot, benjamin opot2, charles okello okudo2, edwin mwakio 2, gladys chemwor, jackline a. Drug resistance in malaria centers for disease control. Epidemiology of drugresistant malaria sciencedirect.
According to the latest bulletin from the who mekong malaria elimination programme, the reported number of p. Elimination of the malaria parasites that caused the treated illness. In the past 21 years, a modest increase in the range of antimalarial drugs approved for clinical use has been complemented by a more impressive expansion in the analysis and understanding of the molecular mechanisms underlying resistance to these agents. The spread of drug resistance is making malaria control increasingly difficult. Epidemiology of malaria and chloroquine resistance in. In 2018, the world health organization who reported that 219 million cases of malaria occurred worldwide, down from 239 million cases in 2010. Malaria remains a leading cause of morbidity and mortality in africa, particularly among young children and pregnant women world health organization who 2000. Malaria causes symptoms that typically include fever, tiredness, vomiting, and headaches. Genomic epidemiology of artemisinin resistant malaria elife. Drug resistance in malaria world health organization. Artemisinin based combination therapies or acts, introduced in.
Malaria can be treated with various drugs, with artemisininbased. Request pdf epidemiology of drugresistant malaria since the first reports of chloroquineresistant falciparum malaria in southeast asia and south america. In 2012 malaria led to 216 million clinical episodes, and 655,000 deaths. Continuous monitoring of their efficacy is needed to inform treatment policies in malariaendemic countries, and to ensure early detection of, and response to, drug resistance. Pdf epidemiology of drugresistant malaria in republic of congo. A section is also devoted to the distribution of drug resistant plasmodium falciparum as this problem is becoming one of the most serious obstacles to curbing mortality.
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