Kuroneko wrote: ↑Mon Mar 05, 2018 4:05 pm A little bit about Malaria treatment and drug resistance in Cambodia:Malaria wars Leslie Roberts* Science 22 Apr 2016: Vol. 352, Issue 6284, pp. 398-405

A disaster is looming in Cambodia and the rest of the Greater Mekong subregion: A deadly malaria parasite has become resistant to both drugs used in the so-called artemisinin combination therapy, raising the specter of untreatable malaria. http://science.sciencemag.org/content/352/6284/398

ACTs (Artemisinin combination therapy) pair the drug artemisinin or one of its derivatives with one of five partner drugs; different combinations are used in different parts of the world. They all pack a one-two punch: Artemisinin hits hard and fast, wiping out malaria parasites in hours , while the longer-acting partner drug mops up any stragglers…..

Around 2008, two teams, including one led by Dondorp, found that parasites were developing resistance to artemisinin in western Cambodia…..

Things got worse in 2015, when scientists found that the partner drug used in Cambodia, piperaquine, was failing, too. When parasites are resistant to the artemisinin component, the drug still works, but more slowly. When piperaquine resistance emerges as well, treatment fails: Patients get better, but a month later they are sick again. The failure rate for this ACT has now reached 90% in western Cambodia; in Vietnam, it has already hit 30%.

The new evidence is solid and "very alarming," says Chris Plowe, who runs the Institute for Global Health at the University of Maryland’s School of Medicine in Baltimore. For reasons still unclear, resistance to older malaria drugs—including chloroquine and sulfadoxine-pyrimethamine—emerged in Pailin as well and then spread broadly, Plowe points out. "If multidrugresistance can spread from Cambodia to Vietnam, it can and will spread elsewhere," he says.

Malaria experts have been encouraged because so far, parasites resistant to piperaquine are still susceptible to an older drug, mefloquine, that has regained its efficacy after years on the shelf. The Cambodian government has already switched to an ACT that contains mefloquine instead of piperaquine, and Vietnam is doing the same. The expert group recommends increased surveillance in the Mekong, Africa, and elsewhere specifically for the K13 C580Y strain, so other countries can act quickly and switch drugs if needed. But Dondorp and others predict that "mefloquine resistance will emerge quickly,” as will resistance to other partner drugs—raising the prospect of untreatable malaria.
http://www.sciencemag.org/news/2017/10/ ... lobal-risk




(MAP) G. GRULLÓN/SCIENCE; (DATA) M. IMWONG ET AL., THE LANCET INFECTIOUS DISEASES 17, 10 © ELSEVIER LIMITED

The threat of artemisinin resistant malaria in Southeast Asia Travel Med Infect Dis. 2016 Nov-Dec; 14(6): 548–550.
https://www.ncbi.nlm.nih.gov/pmc/articl ... f/main.pdf

Jerry Atrick wrote: ↑Tue Mar 06, 2018 9:46 am

Common side effects of Malarone include:

nausea,
vomiting,
abdominal pain,
upset stomach,
headache,
diarrhea,
weakness,
loss of appetite,
itching, and
dizziness.

Tell your doctor if you have rare but very serious side effects of Malarone including:

signs of serious liver problems (such as persistent or severe nausea and vomiting, abdominal pain, unexplained tiredness, dark urine, yellowing eyes or skin),
signs of anemia (such as worsening tiredness, rapid breathing, pale skin/lips/nails, fast heartbeat while resting), or
signs of severe infection (such as high fever, severe chills, body aches, sore throat).

https://www.rxlist.com/malarone-side-ef ... center.htm