Thailand battles drug-resistant malaria strains that imperil global campaign

[rooster59]

Thailand battles drug-resistant malaria strains that imperil global campaign

By Panu Wongcha-um and Prapan Chankaew

 

Anopheles minimus mosquitoes are pictured at a lab in the Public Health Ministry in Bangkok, Thailand, November 9, 2017. Picture taken November 9, 2017.REUTERS/Athit Perawongmetha

 

BO RAI, Thailand (Reuters) - Once a smuggling stop for Cambodia's Khmer Rouge guerrillas, Thailand's border town of Bo Rai finds itself on the frontline of a new battle against drug-resistant strains of malaria that could frustrate global attempts to stamp out the disease.

 

Malaria killed about 445,000 people last year, more than 90 percent of them in sub-Saharan Africa, but the figure has nearly halved since 2000.

 

Now the hard-won gains are at risk from the latest drug-resistant form, which emerged in Cambodia before spreading to Laos, Thailand and Vietnam.

 

"What we are concerned about is that a patient with the disease travels between countries and that risks the spread of infection," said Vicharn Phatirat, who heads the mobile disease control unit in Bo Rai, 300 km (190 miles) east of Bangkok, the capital.

 

Health officials monitor victims of the mosquito-borne disease closely, to ensure they complete their treatment, which limits chances for the disease to become resistant to drugs, as well as to identify carriers of resistant strains.Still resistance is emerging in Southeast Asia to the drugs artemisinin and piperaquine, critical in the fight against malaria, which has seen billions of dollars spent to help avert infection and cut diagnosis time and costs.

 

"The parasite strains are spreading quite quickly at the moment through Cambodia to the neighboring countries," said Arjen Dondorp, the head of malaria research at Mahidol-Oxford's Tropical Medicine unit in Thailand.

 

Scientists fear a repeat of the global malaria resurgence after drug-resistant parasites emerged in Southeast Asia from the 1950s to the 1970s.

 

THAILAND CRITICAL

 

"The border areas have traditionally been where resistance has spread," said Seth Berkley, chief executive of the GAVI global vaccine alliance, explaining why places like Bo Rai have a critical role in the fight.

 

No longer as busy as during the decades when it was a center for the smuggling of Khmer Rouge gems and supplies, it remains a key border crossing, where 16 malaria cases were detected this year, down from a peak of 774 in 2002.

 

Signs in languages from Burmese to Khmer warn against the danger of malaria. Foreigners, mostly migrant workers, made up just under a third of the malaria patients in Thailand last year, government data shows.

 

"We cannot fully follow up on them taking the medications properly as they constantly move across borders," said Thai health official Vicharn.

 

Fake or substandard drugs widely available in the region may also help boost resistance, rather than killing the parasite.

 

The best way to halt resistant strains is to eradicate the disease, once endemic across southern Europe and parts of the United States.

 

Thailand hopes to wipe out malaria by 2024, with fewer than 10,000 cases this year, down nearly 60 percent from 2016.

"We have entered the malaria elimination stage," said health official Piti Mongklangoon.

 

 

-- © Copyright Reuters 2017-12-16

[r136dg]

1 hour ago, rooster59 said:

Fake or substandard drugs widely available in the region may also help boost resistance, rather than killing the parasite.

Actually it's more like the way antibiotics are shoveled out for just about anything. Amoxicillin for a cold or stomach ache is pretty common.

[the guest]

You can't beat nature, it has a way of biting back when you least expect it !

[grumbleweed]

Considering  how they found cures for HIV and Ebola, they'll probably have this sorted before the weekend's over

[Airbagwill]

1 hour ago, r136dg said:

Actually it's more like the way antibiotics are shoveled out for just about anything. Amoxicillin for a cold or stomach ache is pretty common.

NO! - Malaria is a parasite!

[Airbagwill]

Although S.E. Asia is not the "number one" (sorry Thailand) for Malaria is is the source of many drug resistant strains. On this occasion, this is not particularly the result of any Thai mismanagement.

[Airbagwill]

1 hour ago, the guest said:

You can't beat nature, it has a way of biting back when you least expect it !

Really? We managed to eradicate smallpox.

[mikebell]

Meanwhile I watch incredulously as Thailand spends millions building mosquito breeding pools.  Every job putting in drains involves making a chamber every ten metres.  The stagnant water is a perfect place for the female to lay her 400 eggs after biting.

[bitterbatter]

Wait a second.... Malaria has always been drug resistant.  What kind of bs is this headline?  Is it a prelude to some new vaccine like the dengue vaccine?  That worked out real well!!!

 

Let me be clear, drugs are pharmaceuticals controlled by copyrighted substances, while natural medicine and cures remain solutions outside of monopolized products

Edited December 16, 2017 by bitterbatter

[Chris Lawrence]

4 hours ago, rooster59 said:

"What we are concerned about is that a patient with the disease travels between countries and that risks the spread of infection," said Vicharn Phatirat, who heads the mobile disease control unit in Bo Rai, 300 km (190 miles) east of Bangkok, the capital.

Malaria is not spread from person to person like a cold or the flu, and it cannot be sexually transmitted. You cannot get malaria from casual contact with malaria-infected people, such as sitting next to someone who has malaria. CDC web site.

 

So what is this fellow implying?

 

Its a terrible disease. A few guys at boarding school got a reoccurrence of Malaria. They were sick for about 5 days, fever and sore.

 

 

[Airbagwill]

2 hours ago, OmarZaid said:

Here's the cure

 

https://www.naturalnews.com/2017-05-07-malaria-cure-developed-by-academic-institute-found-to-have-been-documented-in-ancient-chinese-medicine-text-written-over-five-centuries-ago.html

Get the facts straight!

Dr. Tu Youyou  was awarded the Nobel Prize in Physiology or Medicine (half, actually—she shared it) for her discovery of artemisinin, a critically important drug in the very small arsenal of drugs that are useful against malaria, which is still the scourge of Africa, despite considerable progress over the past decade. 

 Dr. Tu's discovery has saved hundreds of thousands of lives, and it took some very clever science to accomplish what she did. But, it wasn't Chinese medicine. It was one well-known and long-used branch of drug discovery called natural products chemistry. The only thing Chinese about the discovery was the scientist, and the country in which it was done. - [Science 20 - 2015]

Edited December 16, 2017 by Airbagwill

[metisdead]

Some posts containing some inaccurate medical cures which would be harmful to others have been removed as well as the replies. 

[Suradit69]

3 hours ago, Airbagwill said:

NO! - Malaria is a parasite!

Having had malaria more often than I care to remember while living in Africa, I have never understood why doxycycline was considered a treatment for malaria.

 

As I recall various formulations of Chloroquine phosphate  or Fansidar always seemed to work for me, but what works in one region is often useless in other areas.

 

Unfortunately the overuse of drugs as a prophylaxis among the indigenous population seemed to reduce their natural immunity and increase drug resistance when it came to treatment.

[SunsetT]

4 hours ago, the guest said:

You can't beat nature, it has a way of biting back when you least expect it !

Sure. Mother Nature is trying to kill us all the time. To promote the number one law of nature; the survival of the fittest.

[fishbrando]

5 hours ago, the guest said:

You can't beat nature, it has a way of biting back when you least expect it !

Life finds a way: 

 

[OmarZaid]

2 hours ago, Airbagwill said:

Get the facts straight!

Dr. Tu Youyou  was awarded the Nobel Prize in Physiology or Medicine (half, actually—she shared it) for her discovery of artemisinin, a critically important drug in the very small arsenal of drugs that are useful against malaria, which is still the scourge of Africa, despite considerable progress over the past decade. 

 Dr. Tu's discovery has saved hundreds of thousands of lives, and it took some very clever science to accomplish what she did. But, it wasn't Chinese medicine. It was one well-known and long-used branch of drug discovery called natural products chemistry. The only thing Chinese about the discovery was the scientist, and the country in which it was done. - [Science 20 - 2015]

Bit defensive eh ? -- article says nothing about any Nobel !  Says dying patients ate the leaves and got better. Rx found in ancient Chinese Text ... 'So what' if a compound is isolated by modern analysis ! ?? What's your beef chappie? Grow the tree and harvest the leaves ... not a case of discovery at all --- she  found something someone else knew about and wrote down a long long time ago . . . and God bless her for it  .... That Nobel ain't got nothing to do with nothin !  It's just white folks patting their own shoulders . . .

[Airbagwill]

1 hour ago, Suradit69 said:

Having had malaria more often than I care to remember while living in Africa, I have never understood why doxycycline was considered a treatment for malaria.

 

As I recall various formulations of Chloroquine phosphate  or Fansidar always seemed to work for me, but what works in one region is often useless in other areas.

 

Unfortunately the overuse of drugs as a prophylaxis among the indigenous population seemed to reduce their natural immunity and increase drug resistance when it came to treatment.

It is the parasites that become resistant to the drugs, not the people.

[Suradit69]

1 hour ago, Airbagwill said:

It is the parasites that become resistant to the drugs, not the people.

I was speaking of a natural immunity that indigenous people develop to malaria in their area.

 

If prophylaxis is imposed on people, they experience greater susceptibility to the consequences of parasite exposure.

 

Those populations are less likely to respond positively to treatment because the parasites become resistant and because their natural immunity has been compromised.

 

25 years in an area that was heavily infested by malarial parasite laden mosquitoes. Never took prophylaxis and, following a couple of bad cases early on, after that I could easily avoid the worse consequences with a single does of 1 g chloroquine phosphate (600 mg base).

 

Local population and others from rural areas who had never taken prophylaxis anti-malarial drugs usually responded with equal ease. Those from urban areas where mosquito control was greater, especially those who regularly took anti-malarials like Primaquine, inevitably were less easily treated.

 

Quote

Naturally acquired immunity to falciparum malaria protects millions of people routinely exposed to Plasmodium falciparum infection from severe disease and death. There is no clear concept about how this protection works. 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2620631/

 

While the process that leads to natural immunity is not well understood, the fact remains that people who have not been exposed to over-use of prophylactic drugs tend to be better protected regardless of parasite drug resistance.

 

 

 

 

Edited December 16, 2017 by Suradit69

[Airbagwill]

"If prophylaxis is imposed on people, they experience greater susceptibility to the consequences of parasite exposure." - yes you can find all sorts on Google......

 but this is not shown to be the case

there are basically 2 kinds of immunity neither of which are 100%

Genetic - blood cells such as sickle cell are more resistant to the parasite.

Acquired - After repeated attacks of malaria a person may develop a partially protective immunity particularly in kids who have been repeatedly infected.

 

it is the parasites not the humans that have developed resistance to anti-malarial drugs.

There is as yet no vaccine either....

Basically the use of anti-malarials over 50 years as allowed the parasites to evolve.

This is why a drug based solution is not the only approach......eliminating the parasite and the vectors ability to carry or eliminating the vector are other approaches. Remember the disease has been virtually eliminated in EU and USA.

Edited December 16, 2017 by Airbagwill

[Nigel Garvie]

1 hour ago, Airbagwill said:

it is the parasites not the humans that have developed resistance to anti-malarial drugs.

There is as yet no vaccine either....

Basically the use of anti-malarials over 50 years as allowed the parasites to evolve.

This is why a drug based solution is not the only approach......eliminating the parasite and the vectors ability to carry or eliminating the vector are other approaches. Remember the disease has been virtually eliminated in EU and USA

I totally agree, that it is the parasites not the humans that develop resistance, it should go without saying. What the humans do, in some cases, is develop partial protection against the effects of the disease. Whether drug treatment taken when not needed (As in the anti malarial meds given by UK doctors to travellers) reduce the response to the actual disease if contracted later, is hard to determine. These meds are certainly not well tolerated by the liver, and unwise to take for any length of time. 

 

One of the most promising approaches is to destroy the carriers, as breeding mosquitos with an infertility gene has already proven on a small scale. Only a few of the 100's of mosquito breeds carry the parasite, but doubtless there will still be pathetic idiots complaining about loss of bio diversity.

[fandango71]

8 hours ago, Chris Lawrence said:

Malaria is not spread from person to person like a cold or the flu, and it cannot be sexually transmitted. You cannot get malaria from casual contact with malaria-infected people, such as sitting next to someone who has malaria. CDC web site.

 

So what is this fellow implying?

 

Its a terrible disease. A few guys at boarding school got a reoccurrence of Malaria. They were sick for about 5 days, fever and sore.

 

 

 

I guess the fellow is implying that if somebody who is infected with the resistant strain travels to an area that does not yet have that resistant strain they could then be bitten by a mosquito that could then acquire that resistant strain. 

 

That mosquito could then go on to bite and infect other people in that area who could then be bitten by other mosquitoes that could also acquire the resistant strain and so on and so on until the new resistant strain becomes established in the area that didn't previously have it.

 

I am no expert but it's kinda scary if that is how it does spread.

[Dumbastheycome]

9 hours ago, Chris Lawrence said:

Malaria is not spread from person to person like a cold or the flu, and it cannot be sexually transmitted. You cannot get malaria from casual contact with malaria-infected people, such as sitting next to someone who has malaria. CDC web site.

 

So what is this fellow implying?

 

Its a terrible disease. A few guys at boarding school got a reoccurrence of Malaria. They were sick for about 5 days, fever and sore.

 

 

A person  infected  by the   new  strain  who  is  bitten  by and thus creates  a vector carrier   mosquito  that then infects   new   victims...

So sitting next  to an infected  person  while  in the  presence  of  mosquitoes who  are   feeding  on  both  of  you   is  not  so far  removed  from  direct transmission. Admittedly there  is  actually a  time  span   that is  required   for  the   mosquito  to   actually  pass on  the infection it but  amounts  to the  same  thing. Previous  strains have  been  curable  but  resistant  strains  not  easily. 

There  is  an  existing  proposal  to  genetically   alter  mosquitoes  to  prevent  thier  capacity  to  carry  the  disease. Curiously  or  not  it  has  never been  adopted  as a  world  health  strategy. Treatment  rather than cure  probably  has  an economic  windfall  that  over rides  the  effectiveness despite  the  misery it  causes  to  millions  of (which  decile ? ) people.

 

[Chris Lawrence]

7 hours ago, Dumbastheycome said:

A person  infected  by the   new  strain  who  is  bitten  by and thus creates  a vector carrier   mosquito  that then infects   new   victims...

So sitting next  to an infected  person  while  in the  presence  of  mosquitoes who  are   feeding  on  both  of  you   is  not  so far  removed  from  direct transmission. Admittedly there  is  actually a  time  span   that is  required   for  the   mosquito  to   actually  pass on  the infection it but  amounts  to the  same  thing. Previous  strains have  been  curable  but  resistant  strains  not  easily. 

There  is  an  existing  proposal  to  genetically   alter  mosquitoes  to  prevent  thier  capacity  to  carry  the  disease. Curiously  or  not  it  has  never been  adopted  as a  world  health  strategy. Treatment  rather than cure  probably  has  an economic  windfall  that  over rides  the  effectiveness despite  the  misery it  causes  to  millions  of (which  decile ? ) people.

 

Did you work this out or have you got medical evidence this occurs? I was quoting from World Health source.

 

A few billion dollars went towards helping African nations. Maybe this is a plea for some of that pie?

[Airbagwill]

"A person  infected  by the   new  strain  who  is  bitten  by and thus creates  a vector carrier   mosquito  that then infects   new   victims...

So sitting next  to an infected  person  while  in the  presence  of  mosquitoes who  are   feeding  on  both  of  you   is  not  so far  removed  from  direct transmission. Admittedly there  is  actually a  time  span   that is  required   for  the   mosquito  to   actually  pass on  the infection it but  amounts  to the  same  thing. Previous  strains have  been  curable  but  resistant  strains  not  easily. 

There  is  an  existing  proposal  to  genetically   alter  mosquitoes  to  prevent  thier  capacity  to  carry  the  disease. Curiously  or  not  it  has  never been  adopted  as a  world  health  strategy. Treatment  rather than cure  probably  has  an economic  windfall  that  over rides  the  effectiveness despite  the  misery it  causes  to  millions  of (which  decile ? ) people."

 

1 hour ago, Chris Lawrence said:

Did you work this out or have you got medical evidence this occurs? I was quoting from World Health source.

 

A few billion dollars went towards helping African nations. Maybe this is a plea for some of that pie?

Dumbastheycome - I think you are misinformed about the way that the parasites are transmitted.

 

Malarial parasites have 2 life cycles.

In humans they live in liver and blood but can produce further organisms that increase damage to their human host.

 

For a person to be infected initially, they have to be bitten by a mozzie cpble of transmitting the disease. To do this the mosquito has to ingest blood from an infected human.......then it takes 10 to 18 days from ingestion to getting to the mozzies salivary glands.  (as "sporozoites") - it is only then that the parasites can be successfully injected into another human.

 

Furthermore only the female mosquito needs blood meals and these are taken only once or twice a day.

 

So being near a malarial patient doesn’t bear the risk of immediate “direct” infection as the mosquito would need up to 18 days to be able to transfer the parasite. The risk would be about the same in any malarial area regardless of proximity of humans.

 

The frequency of mozzies biting habits and the time taken for the parasite to develop in the mosquito mean that a mozzie can't just hop from one person to another and spread the disease.

Edited December 17, 2017 by Airbagwill

[YetAnother]

23 hours ago, r136dg said:

Actually it's more like the way antibiotics are shoveled out for just about anything. Amoxicillin for a cold or stomach ache is pretty common.

Thais feel under-treated if they walk away from a medical facility without pills; 

this expectation is now endemic, regardless of whether they need the pills, or they are the right pills or of cross-medicine side effects

[rotorbreeze]

4 hours ago, Airbagwill said:

"A person  infected  by the   new  strain  who  is  bitten  by and thus creates  a vector carrier   mosquito  that then infects   new   victims...

So sitting next  to an infected  person  while  in the  presence  of  mosquitoes who  are   feeding  on  both  of  you   is  not  so far  removed  from  direct transmission. Admittedly there  is  actually a  time  span   that is  required   for  the   mosquito  to   actually  pass on  the infection it but  amounts  to the  same  thing. Previous  strains have  been  curable  but  resistant  strains  not  easily. 

There  is  an  existing  proposal  to  genetically   alter  mosquitoes  to  prevent  thier  capacity  to  carry  the  disease. Curiously  or  not  it  has  never been  adopted  as a  world  health  strategy. Treatment  rather than cure  probably  has  an economic  windfall  that  over rides  the  effectiveness despite  the  misery it  causes  to  millions  of (which  decile ? ) people."

 

Dumbastheycome - I think you are misinformed about the way that the parasites are transmitted.

 

Malarial parasites have 2 life cycles.

In humans they live in liver and blood but can produce further organisms that increase damage to their human host.

 

For a person to be infected initially, they have to be bitten by a mozzie cpble of transmitting the disease. To do this the mosquito has to ingest blood from an infected human.......then it takes 10 to 18 days from ingestion to getting to the mozzies salivary glands.  (as "sporozoites") - it is only then that the parasites can be successfully injected into another human.

 

Furthermore only the female mosquito needs blood meals and these are taken only once or twice a day.

 

So being near a malarial patient doesn’t bear the risk of immediate “direct” infection as the mosquito would need up to 18 days to be able to transfer the parasite. The risk would be about the same in any malarial area regardless of proximity of humans.

 

The frequency of mozzies biting habits and the time taken for the parasite to develop in the mosquito mean that a mozzie can't just hop from one person to another and spread the disease.

Have you had malaria... I have on returning from working West Africa for World Health Organization in 1976 and again 10 yrs later in 1986...I was the helicopter engineer looking after the Hughes 500C treating the rivers for Onko a disease called River Blindness spread by the Black Fly in rapids of rivers. Now back to Malaria ..sure the disease is spread to you by mosquito..it is your immune system responds to his invader..if immune system is low..then and only then you get disease...so keep you immune system strong and your gut bacteria high in good... do not take anti-biotics it will kill good bacteria that supports your immune system...at any rate this could be removed..you be the judge and jury education is best..again big Pharma do not want you healthy..no money in healthy people...

[XBroker]

Well, if Reuters says it, it must be true.  I think everyone there should allow the Bill & Linda Gates foundation to inject them w/ something that will stop it. Clearly they're in the business of helping.

Edited December 17, 2017 by XBroker

[metisdead]

A post commenting on moderation regarding removal of "posts containing some inaccurate medical cures" has been removed.  See this forum rule:

 

2) You will not use ThaiVisa.com to post any material which is knowingly or can be reasonably construed as false, inaccurate, invasive of a person's privacy, or otherwise in violation of any law.
 

 

[Airbagwill]

19 hours ago, rotorbreeze said:

Have you had malaria... I have on returning from working West Africa for World Health Organization in 1976 and again 10 yrs later in 1986...I was the helicopter engineer looking after the Hughes 500C treating the rivers for Onko a disease called River Blindness spread by the Black Fly in rapids of rivers. Now back to Malaria ..sure the disease is spread to you by mosquito..it is your immune system responds to his invader..if immune system is low..then and only then you get disease...so keep you immune system strong and your gut bacteria high in good... do not take anti-biotics it will kill good bacteria that supports your immune system...at any rate this could be removed..you be the judge and jury education is best..again big Pharma do not want you healthy..no money in healthy people...

..and your point is?

[alwaysrainsinUK]

Well before you take your kids go get the Dengvaxia vaccine have a read at the latest on it ,seems they made a mess of the testing and only now discover that it makes it worse if later in contact with dengue for kids .......

 

https://www.reuters.com/article/us-sanofi-dengue-science-insight/did-sanofi-who-ignore-warning-signals-on-dengue-vaccine-idUSKBN1E7072?utm_campaign=trueAnthem:+Trending+Content&utm_content=5a30cb4304d3012bdb5913db&utm_medium=trueAnthem&utm_source=twitter