With a reported high incidence of malaria cases due to increased construction activities this year, cases of resistance to anti-malarial drugs have also gone up.
Doctors concerned about resistance to medication, advise use of changing combination of drugs, rather than one kind of therapy
With a reported high incidence of malaria cases due to increased construction activities this year, cases of resistance to anti-malarial drugs have also gone up considerably. To make things worse, the resistance is recorded more in case of the P falciparum strain that accounts for more than 60 per cent of the mortality.
Drug-resistance means that the common drug regimen used to treat malaria fails to kill the parasite, resulting in a relapse of the ailment. Speaking to DNA, director of the Maharashtra University of Health Sciences, Dr Neelima Kshirsagar, said that increasing resistance cases are indeed a cause for concern. Head of the clinical pharmacology department at KEM Hospital that looks into cases of drug-resistance, she added: “Increasingly, the accepted line of treatment for malaria is failing, but there can be many reasons for this.”
According to a study carried out by the clinical pharmacology department of KEM hospital, about five per cent of cases confirmed the existence of Chloroquine resistance in the P falciparum strain in Mumbai. Resistance to the anti-malarial drug could be caused by the parasite that has mutated and does not respond to the commonly-available drugs. Another reason could also be that the drugs were not taken properly, as per the prescription.
Earlier, it took at least 10-15 years for the parasite to develop resistance against an anti-malarial drug. “But this situation is changing fast with doctors having to frequently change the combination of drugs,” Dr Kshirsagar said.
Even the lighter strain of the malaria, Vivax, has been detected showing resistance.
“However, the low prevalence of Vivax resistance that is hardly one to two per cent, still makes Chloroquine the medicine of choice to treat malaria patients,” said Dr Kishore Harugoli of malaria surveillance at the BMC. This year, malaria has already claimed 53 lives, since the onset of the monsoons in June.
Dr Kshirsagar also added that the newer anti-malarial drugs extracted from a Chinese plant need better adherence. “The full course of 7-10 days has to be completed, otherwise the fever comes back,” she said. About 70 per cent of the cases are caused by Vivax. “But the problem of morbidity with relapses in Vivax malaria is of great concern,” she added.
According to guidelines laid out by the World Health Organisation (WHO), the focus of malaria management today largely depends on a combination therapy rather than monotherapy. “The parasite has to mutate to become resistant to the combination, so evolving newer combinations increases the life of the drug used,” said Dr Suhas Ranade, deputy director, Maharashtra Health Services. He added that the cases of resistance are more from districts like Gadchiroli, Chandrapur and Raigad. d_sumitra@dnaindia.net
){kind=small}
){kind=small}
){kind=small}
){kind=small}
){kind=small}
){kind=small}
){kind=small}
){kind=small}
){kind=small}
){kind=small}
){kind=small}
){kind=small}
){kind=small}
){kind=small}
){kind=small}
){kind=small}
){kind=small}
){kind=small}
){kind=small}
){kind=small}
){kind=small}
){kind=small}
){kind=small}
)
){kind=small}
){kind=small}
)
)
)
)
)
){kind=small}
){kind=small}
){kind=small}
){kind=small}
){kind=small}