Breakthrough on malaria cure
Published on: Thursday, January 07, 2016
Kota Kinabalu: A key combination of anti-malarial drugs works well in curing Plasmodium knowlesi (or Monkey Malaria) infection.Principal Investigator for the Monkey Malaria Research Project in Sabah, Dr Timothy William (pic), said this is one of the findings from the first clinical trial ever on people with Monkey Malaria to determine the best treatment for this infection.The monkey parasite (Plasmodium knowlesi) naturally occurs in long-tailed and pig-tailed macques that inhabit forested areas in Southeast Asia. While it causes malaria in monkeys, it also causes Plasmodium knowlesi infection in humans as the parasite can be transmitted from monkeys to humans by the bite of an infected Anopheles mosquito.
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Dr Timothy, an infectious disease physician with Jesselton Medical Centre, led the breakthrough research participated by Dr Matthew Grigg, Prof Nick Anstey, Dr Yeo Tsin Wen and Dr Giri Shan, in which they compared an artemisinin-combination therapy (ACT) called artesunate-mefloquine against chloroquine to see how quickly they clear parasites in the blood. The study was successfully completed in November last year.Speaking to the Daily Express Wednesday, he said: "While a number of different drugs have been used to treat this Plasmodium knowlesi infection, this is the first randomised controlled trial to be conducted for uncomplicated knowlesi malaria to define the optimal treatment in both adults and children. "The results showed that while both drugs (ACT and chloroquine) were able to cure the infection, ACT was able to clear parasites and fever faster allowing earlier hospital discharge, and also reduced the risk of anaemia."
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On the importance of the study, Dr Timothy said the World Health Organisation (WHO) had only recently recommended ACT for Plasmodium knowlesi malaria, in their 2015 Malaria Treatment Guidelines."However, ours is the first study specifically designed to provide evidence for this policy change. Just because other species of malaria parasites causing infection in Sabah look similar under the microscope to the monkey parasites, they are often misdiagnosed as each other.
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"As these other parasites are usually resistant to chloroquine, treating them with chloroquine as though they are monkey malaria can have dangerous consequences. We have now shown that all species respond well to ACT, including monkey malaria. This means we can safely use ACT for malaria caused by all the malaria species in Malaysia," the doctor explained.Describing these findings as groundbreaking and a significant success for the Malaysian Ministry of Health, Dr Timothy said the results will be disseminated to inform about the Plasmodium knowlesi malaria treatment policy in this region.The study has just been published in the prestigious international journal, Lancet Infectious Diseases, the second top medical journal in the world.From another perspective, Dr Timothy said the Sabah breakthrough is also a scientific contribution from Scientific Research done in Sabah for the world Scientific and Medical community. "It has major implications in the treatment of Monkey Malaria in Malaysia, especially Sabah and also the region."Based on the study, the Principal Investigator said Plasmodium knowlesi infection is now an emerging infection in humans, given the large number of infected patients in Sabah, in particular, and in Southeast Asia, in general. "Its history of discovery indicates that infection with Plasmodium knowlesi has occurred in Malaysia since the 1990s.""Although malaria has existed since time immemorial, Plasmodium knowlesi malaria is a relatively new disease in terms of how it transitioned from an infection in monkeys to infection in humans. "This monkey parasite has become the most common cause of human malaria in Malaysia, and is also found throughout Southeast Asia in countries like Thailand, Singapore, the Philippines, Vietnam, Myanmar and Indonesia. "In fact, it is now known to cause 70pc of the malaria cases in certain areas of Sarawak," he pointed out.Researchers from Queen Elizabeth Hospital (QEH), Kota Kinabalu, Sabah State Health Department, QEH Cinical Research Centre and Jesselton Medical Centre, Kota Kinabalu, together with the Menzies School of Health Research in Darwin, Australia, conducted the inaugural clinical trial in Sabah.The project was funded by the Ministry of Health (MOH) Research grant where the clinical researchers worked in collaboration with a number of MOH hospital sites.These include Kudat, Kota Marudu and Pitas District Hospitals, community and local government stakeholders in Sabah, Malaysia, pooling their resources to conduct this research project.Stay up-to-date by following Daily Express’s Telegram channel.
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