The border region of Cambodia and Thailand has been a battleground of medicine, bacteria and parasites. Unfortunately, the medicines seem to be losing the fight, again. A recent article in the New England Journal of Medicine looks at the evolution of Artemisinin resistant Plasmodium Falciparum, and the news is not good. This region of the world has also previously spawned quinolone resistant Campylobacter bacteria, implicated in virulent strains of diarrhea.
Artemisinin, an ancient treatment for malaria, has previously been the “big gun” in the world-wide war against P. Falciparum, considered to be the most severe and deadliest form of malaria. With the development of resistance in Thailand/Cambodia, once can only wonder how much longer will this medicine be effective?
The emergence of drug resistance, in any bacteria or parasite, is multi-factorial. Improper use of medicines, such as not completing a full course of treatment or the use of “fake malaria medication” which has become more prevalent. Some times, malaria medicine is produced and sold by unscrupulous manufacturers and actually contains just enough of the active medicine to pass inspection. The concern is that by taking this counterfeit medicine, one receives just enough of a dose to allow the malaria parasite to adapt and over come the medicine, without actually stopping the infection. This breeds a resistant form of the disease, making it immune to the previous medicine.