Researchers worry as malaria becomes ‘untreatable’

• Nigeria does not have documented drug resistance, says NMEP
Scientists have raised fresh alert to the rapid spread of ‘super malaria’ in South East Asia, which they say pose a global threat to efforts to eliminate the mosquito-borne disease.

They fear that this dangerous form of the malaria parasite has become untreatable with the World Health Organisation (WHO) recommended drug-of-choice, Artemisinin-based Combination Therapy (ACT).

The researchers from the Mahidol-Oxford Tropical Medicine Research Unit in Bangkok in their study published in The Lancet Infectious warned that the menace is spreading. It emerged in Cambodia but has since spread through parts of Thailand, Laos and has arrived in southern Vietnam.

The fear is palpable in Nigeria and indeed Africa where resistance to the drugs would be catastrophic, since 92 per cent of all malaria cases happen in the continent.

Reacting to the latest study, Head Case Management, National Malaria Elimination Programme (NMEP), Dr. Godwin Ntadom, yesterday, told The Guardian: “For now, we have not documented resistance in Nigeria, and to the best of my knowledge in any part of West Africa. There may have been few reported cases of delayed parasite clearance in some other parts of Africa, but certainly not resistance. The challenge we often have is that people confused ‘treatment failure’ with ‘resistance’.

“Before you have resistance, you will begin to record what is technically described as ‘delayed parasite clearance’ and from there it progresses to resistance after some time.”

Ntadom said resistance is only confirmed through studies where quality assured medicines are administered at the appropriate doses to a group of closely monitored patients who have been confirmed to have malaria, and followed up for about 28 to 42 days.

On the result of NMEP’s recent study on malaria drug resistance in Nigeria, Ntadom said: “Unfortunately, we are yet to produce the final report of the 2015 Drug Therapeutic Efficacy Tests conducted in the country. As you are aware, the whole study was funded through Global Funds support and the United State Presidential Malaria Initiative (USPMI). With the suspension of the Global Fund support in 2016, we could not go on.’’

Also, the Nigeria Institute of Medical Research (NIMR) had in June 2017 raised alarm over the increasing incidence of mosquito resistance to Long Lasting Insecticide Nets (LLINs) in 18 states of the federation, even as over 50 million Nigerians still test positive to malaria annually.

According to NMEP, Nigeria has 25 per cent of the world’s disease burden for malaria and reports more deaths due to this disease than any other country in the world.

In Nigeria, malaria is responsible for the deaths of an estimated 300,000 children per year and contributes to over 4,000 maternal deaths annually. It is also the number one cause of absenteeism in Nigeria, resulting in loss in productivity at work and school.

The NMEP reports that 97 per cent percent of Nigerians are at risk from malaria, with an estimated 50 percent of adults suffering at least one episode of the disease a year. Malaria counts for 60 percent of out- patient visit and 30 percent of hospitalisations.