By IANS,
Washington : Scientists employing a sophisticated computer model have determined that governments worldwide are advocating the wrong kind of malaria treatment.
Despite the availability of many drugs and therapies to treat malaria, many countries’ policies recommend using what is known as a single first-line therapy – that is, using one drug repeatedly with many patients.
A team led by Maciej Boni, post-doctoral fellow at Princeton and scholar at Resources for the Future, a Washington-based think tank, reported that countries could cut the death rate and forestall the development of drug resistance if a variety of different drugs were distributed to patients.
This approach, known as multiple first-line therapies or MFT, could be put in place by ensuring the same price range for different drugs, so that patients would not be forced to buy the cheapest available drug but would choose from a random pool.
“What we found is that using multiple first-line therapies is the best way to avoid treatment failures and to delay the development of resistance for as long as possible,” said Boni, who recently has joined the staff of Oxford University Clinical Research Unit in Ho Chi Minh City, Vietnam.
One catch to the researchers’ strategy is that multiple effective therapies may not always be available. In some African countries where drug-resistance is already widespread, the only effective therapies are a class of drugs known as artemisinin-based combination therapies (ACTs).
“MFT does not necessarily solve all our problems,” said Boni. “Antimalarial drug development needs to continue with the hope of producing novel and highly effective antimalarials that can be deployed alongside ACTs.”
Some 350 to 500 million people are infected with malaria every year by being bitten by a mosquito carrying one of the four human malaria parasites, P. falciparum, P. vivax, P. malaria or P. ovale, according to statistics maintained by the World Health Organisation.
Falciparum infections are by far the most common, killing more than a million people each year. Malaria also contributes indirectly to many more deaths, mainly in young children, among those already suffering from other infections and illnesses. About 60 percent of the cases of malaria worldwide and more than 80 percent of malaria deaths occur in sub-Saharan Africa.
Boni, a mathematician as well as an evolutionary biologist, and his co-authors, Ramanan Laxminarayan and David Smith, designed a computer model with inputs based on more than 100 years of malaria field research.
They found there were major benefits to employing an MFT strategy, namely, fewer cases of malaria, fewer unsuccessful drug treatments, and a very significant delay in the onset of drug resistance in the parasites.
The findings will appear in the Sep 16 issue of the Proceedings of the National Academy of Sciences.