Reply to: Are you a Rotarian working on malaria?
Yes, I am a Rotarian from RC Luxembourg Vallées. 10 years ago we launched programs in Africa and South America promoting the use of the Artemisia annua or Artemisia afra plants against malaria and other tropical diseases. Several clinical trials, the last one in RDCongo have demonstrated the high efficacy of this herbal medicine against malaria. Not only in therapy, but also in prophylaxy and in transmission inhibition, After 7 days of drinking the infusion there are no parasites-gametocytes left in the blood.
Rotarians from Belgium, France and Africa have joined us. We now work with 12 universities in Africa and South America, Artemisia plantations managed by local organisations produce tons of dried Artemisia leaves in 10 countries. A cheap and affordable cure locally available. It has become a breakthrough achieved by young agronomists and medical doctors from Africa.
We deplore that these efforts are barely recognized and receive little support from the official Rotary Malaria Programs, They prefer to work with imported Bigpharma drugs, often too expensive for an African household.
On this topic we recommend the film "Malaria Business" (Bernard Crutzen, RTBF, FR-0) now available on YouTube.
Reply to: Bone Marrow and Hypnozoite-Independent Plasmodium vivax Malarial Recurrences
The spleen is also a likely source of hypnozoite-unrelated P. vivax recurrences. Although not reflected by the abstract, the matter of a splenic origin is discussed in "New Evidence for Hypnozoite-Independent Plasmodium vivax Malarial Recurrences" (https://doi.org/10.1016/j.pt.2018.08.010). The subject of the spleen came up in this context last week at the P. vivax conference in Paris.
Reply to: Artemisinin resistance in Africa.
Not only residents in Africa are affected by ACT resistance. Also travelers returning from malaria endemic areas are victims of the same failures.
A retrospective comparative analysis of treatment regimen for P. falciparum malaria in adults in Stockholm during 2000-2015 was performed to evaluate the effectiveness of artemether-lumefantrine. Parasite genotyping and drug concentrations were investigated in the AL treatment failures.
AL failures occurred in European men and the effectiveness in this group was only 73.7% (95% CI, 48.8%-90.0%). Genotyping confirmed recrudescence of the initial parasite populations and drug resistance markers revealed no clinically significant resistance patterns. Lumefantrine concentrations suggested subtherapeutic concentrations in at least 2 cases. These findings indicate a high rate of symptomatic late treatment failures after 6-dose AL regime in nonimmune adults, especially in men. The report warrants the need to alert clinicians about the importance of informing patients regarding the risk of parasites reappearing weeks after AL treatment.
Sondén K, Wyss K, High Rate of Treatment Failures in Nonimmune Travelers Treated With Artemether-Lumefantrine for Uncomplicated Plasmodium falciparum Malaria in Sweden: Retrospective Comparative Analysis of Effectiveness and Case Series. Clin Infect Dis. 2017 Jan 15;64(2):199-206. doi: 10.1093/cid/ciw710.
Four British citizens who caught malaria while travelling in Africa have shown apparent resistance to the main drug used to treat the disease, according to researchers at the London School of Hygiene and Tropical Medicine. Scientists say the discovery should act as a warning for Africa, where the drug has played a key role in sharply reducing mortality rates from malaria.
The four travellers were treated with a drug called Artemether-Lumefantrine after returning to Britain from different parts of Africa within a five-month period, showing symptoms of malaria.
The cases alerted scientists at the London School of Hygiene and Tropical Medicine
Sutherland CJ, Lansdell. P3pfk13-Independent Treatment Failure in Four Imported Cases of Plasmodium falciparum Malaria treated with Artemether-Lumefantrine in the United Kingdom. Antimicrob Agents Chemother. 2017 Feb 23;61(3). pii: e02382-16. doi: 10.1128/AAC.02382-16. Print 2017 Mar.
Tunesia reports a case of possible clinical failure of artemether-lumefantrine treatment in a 26-year old Tunisian traveler with uncomplicated P. falciparum malaria imported from Cote d’Ivoire
Aouam A, Toumi A, Ikbel K, Brahim HB, Loussaief C, et al. Artemether–Lumefantrine Treatment Failure in a Falciparum Malaria Patient in Tunisia. J Neurol Transl Neurosci. 2016. 4(1): 1060
Another study reports the case of three, non-immune, expatriate workers with P. falciparum acquired in Africa, who failed to respond to artemisinin-based therapy.
Yves Jackson, François Chappuis, Louis Loutan, and Walter Taylor. Malaria treatment failures after artemisinin-based therapy in three expatriates: could improved manufacturer information help to decrease the risk of treatment failure? Malar J. 2006; 5: 81.
Neumayr A, Paris DH, Genton B, Hatz C. Artemether-Lumefantrine Treatment Failure in Nonimmune European Travelers with Plasmodium falciparum Malaria: Do We Need to Reconsider Dosing in Patients From Nonendemic Regions? Clin Infect Dis. 2017 May 15;64(10):1466-1467
Reply to: Why does vivax malaria recur?
Considerable support was received at the 7th International Conference on Plasmodium vivax Research (Paris, 26–28 June 2019) for the idea of parasite accumulation (and reproduction) outside the peripheral blood circulation; and, therefore, for this non-hypnozoite recurrence concept.
Reply to: Biology of Recurrences in Plasmodium vivax Malaria
A poster presented at the conference also dealt with this subject. See: