NEW: Asia Parasitological Response Study Group

A pooled analysis of early parasitological response to artemisinin combination therapy (ACT) in Asia

Slow clinical and parasitological response after artemisinin antimalarial therapy for uncomplicated Plasmodium falciparum malaria has emerged in western Cambodia. Subsequently, similar delayed responses have been confirmed in Thailand, Vietnam and more recently in Myanmar ^[1]. The spread of these slow-clearing parasites poses a major global public health threat, with the greatest potential impact in sub-Saharan Africa where the majority of deaths from malaria occur in small children ^[2].

If resistance to artemisinin compounds spreads, it will likely follow the path seen for resistance to chloroquine and sulfadoxine/pyrimethamine, and propagate from the Mekong region through South Asia and into Eastern Africa. Alternatively, artemisinin drug resistance may develop de novo in South Asia or Africa before these parasites spread from the Mekong.

To respond to the threat of resistance, WWARN is forming a collaborative study group to assess the parasite clearance times for artemisinin combination therapeutic (ACT) efficacy trials conducted throughout Asia in the past decade.

The objectives of this assessment are:

• * To define the spectrum of early parasitological response following ACT in Asian clinical trials
• * To identify the cofactors affecting early and late treatment outcomes
• * To investigate geographical and temporal trends in early parasitological outcomes that, after controlling for confounding factors, may indicate declining artemisinin drug efficacy.

“Much like Africa, areas outside the Mekong region need to look for subtle temporal changes in parasite clearance times after ACT to identify indicators of early antimalarial drug resistance” stated Dr. Abdoulaye Djimde, Chief of the Molecular Epidemiology and Drug Resistance Unit at the Malaria Research and Training Centre University of Bamako, Mali and member of the WWARN’s ACT Africa Baseline Study Group. Dr Djimde confirms “There is clear benefit for Asian malaria researchers to conduct similar analyses as we have already performed in Africa, especially outside the Mekong region.”

This study group is currently forming. We are looking for two junior malaria researchers working in Asia who can help coordinate this study group with administrative and statistical support from the WWARN data management team. We expect to upload appropriate data sets into the WWARN Data Centre in March, and begin pooled analyses thereafter with a view to completing a manuscript for publication by September-October this year.

For more information about joining this study group, please contact info@wwarn.org