New form of malaria threatens Thai-Cambodia border

Tuesday, December 22, 2009

(AP) — EDITOR'S NOTE: Once curable diseases such as tuberculosis and malaria are rapidly mutating into aggressive strains that resist drugs. The reason: The misuse of the very drugs that were supposed to save us has built up drug resistance worldwide. Second in a five-part series.<

PAILIN, Cambodia - O'treng village doesn't look like the epicenter of anything.
Just off a muddy rutted-out road, it is nothing more than a handful of Khmer-style bamboo huts perched crookedly on stilts, tucked among a tangle of cornfields once littered with deadly land mines.

Yet this spot on the Thai-Cambodian border is home to a form of malaria that keeps rendering one powerful drug after another useless. This time, scientists have confirmed the first signs of resistance to the only affordable treatment left in the global medicine cabinet for malaria: Artemisinin.
If this drug stops working, there's no good replacement to combat a disease that kills 1 million annually. As a result, earlier this year international medical leaders declared resistant malaria here a health emergency.
"This is not business as usual. It's something really special and it needs a real concerted effort," said Dr. Nick White, a malaria expert at Mahidol University in Bangkok who has spent decades trying to eradicate the disease from Southeast Asia. "We know that children have been dying in Africa-millions of children have died over the past three decades-and a lot of those deaths have been attributed to drug resistance. And we know that the drug resistance came from the same place."
Malaria is just one of the leading killer infectious diseases battling back in a new and more deadly form, the AP found in a six-month look at the soaring rates of drug resistance worldwide. After decades of the overuse and misuse of antibiotics, diseases like malaria, tuberculosis and staph have started to mutate. The result: The drugs are slowly dying.
Already, The Associated Press found, resistance to malaria has spread faster and wider than previously documented. Dr. White said virtually every case of malaria he sees in western Cambodia is now resistant to drugs. And in the Pailin area, patients given artemisinin take twice as long as those elsewhere to be clear of the parasite-84 hours instead of the typical 48, and sometimes even 96.
Mosquitoes spread this resistant malaria quickly from shack to shack, village to village-and eventually, country to country.
And so O'treng, with its 45 poor families, naked kids, skinny dogs and boiling pots of rice, finds itself at the epicenter of an increasingly desperate worldwide effort to stop a dangerous new version of an old disease.