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article imageMove over Ebola- Malaria next big health crisis

By Karen Graham     Dec 16, 2014 in Health
The World Health Organization recently reported the number of people dying from Malaria has dropped 47 percent in Sub-Saharan Africa since 2000. WHO attributed the success in reducing the number of deaths, in large part, to better diagnosis and treatment.
A health crisis has been going on for the last several years in Myanmar, a country of 50 million people, fitting snugly between the Andaman Sea and the Himalayas bordering India and China. While health care is poor, and what little there is can be considered nominal, some diseases like HIV/AIDS and malaria largely go untreated.
But for those lucky enough to get treatment for malaria, something interesting has started showing up. Normally, when someone tests positive for malaria, they are put on a course of a combination of therapies (ACTs) based on artemisinin, a Chinese herb derivative. After three days, patients will almost always test negative for the mosquito-borne disease.
The spread of artemisinin resistant malaria  parasites is becoming a great concern in Myanmar
The spread of artemisinin resistant malaria parasites is becoming a great concern in Myanmar,
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But in the last year, patients taking the ACTs are ending up still testing positive for malaria after treatment. Many patients will have the fever subside, but continue to be plagued by the headaches. Medical experts are saying they are seeing an indication of a growing drug resistance by the mosquito-borne disease.
A study has already been done on the growing resistance of Plasmodium falciparum, the most deadly of the malaria parasites. Published in the New England Journal of Medicine in August of 2014, the study followed 1241 malaria patients in 10 countries across Asia and Africa, basically confirming what is being seen now in Myanmar.
Local clinic trating malaria patients.
Local clinic trating malaria patients.
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But the real concern is that Myanmar, with the largest malaria burden in the region, is going to end up being "ground zero" for the spread of the artemisinin resistant malaria parasite. Positioned so uniquely on the world map, Myanmar can be the key to halting the spread of the drug-resistant parasite, or if the world fails to act, the starting point for the next global health crisis.
"We need to act fast to avoid a big catastrophe," said Pascal Ringwald of the WHO's Global Malaria Program. "The consequences could be disastrous." Should the problem be allowed to spread, it would create a world crisis. Twice in the past, malaria has built up a resistance to drugs in Myanmar and spread to Africa, killing millions of adults and children.
Why malaria parasites become resistant to drugs is unclear, but experts say a combination of factors could be in play, including internal conflict, thick jungles, migratory patterns and poor quality drugs. The Kayin State Health Minister Aung Kyaw Htwe pointed out a possible reason for the drug-resistant malaria. Many rural shops are selling fake or poor quality malaria drugs. These only make the malaria stronger, he said. "We're trying to educate shopkeepers not to sell these drugs and people not to take them."
More about Malaria, Southeast asia, drugresistant malaria, Myanmar, Ground zero
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