Study suggests malaria resistance continues to rise along Thai-Myanmar border

A new study suggests early diagnosis and treatment with artemisinin based combination treatments has led to a reduction in the number of malaria cases in migrants along the Thai-Myanmar border, despite growing resistance to the drug.

The study, funded by the Oxford Tropical Medicine Research Program and the Wellcome Trust of Great Britain and recently published in the journal PLOS Medicine, could be significant because it points to a need for alternative treatments to replace failing front line malaria medications mefloquine and artesunate.

Fran├žois Nosten from the Shoklo Malaria Research Unit in Thailand, the study's leader, used information collected in the Thai-Myanmar border region between 1999 and 2011 to reach this conclusion. Nosten and his team found that the number of Plasmodium falciparum malaria cases increased until 2006, then declined to 2011.

The decrease was at first considered good news. In the small sample size of patients undertaking drug resistance tests, however, the authors found that the effectiveness of ACTs fell steadily with the proportion of patients on treatment but still infected by day three. That number increased from zero percent in 2000 to 28 percent in 2011.

"Alternative fixed combination treatments are needed urgently to replace the failing first-line regimen of mefloquine and artesunate," the study concludes.