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Malaria drugs fail for first time on patients in UK

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A key malaria treatment has failed for the first time in patients being treated in the UK, doctors say.

The drug combination was unable to cure four patients, who had all visited Africa, in early signs the parasite is evolving resistance.

A team at the London School of Hygiene and Tropical Medicine said it was too early to panic.

But it warned things could suddenly get worse and demanded an urgent appraisal of drug-resistance levels in Africa.

Malaria parasites are spread by bites from infected mosquitoes.

It is a major killer of the under-fives with one child dying from the disease every two minutes.

Between 1,500 and 2,000 people are treated for malaria in the UK each year – always after foreign travel.

Most are treated with the combination drug: artemether-lumefantrine.

But clinical reports, now detailed in the journal Antimicrobial Agents and Chemotherapy, showed the therapy failed in four patients between October 2015 and February 2016.

All initially responded to therapy and were sent home, but were readmitted around a month later when the infection rebounded.

Samples of the parasite that causes malaria were analysed at the Malaria Reference Laboratory at the London School of Hygiene and Tropical Medicine.

Dr Colin Sutherland told the BBC News website: “It’s remarkable there’s been four apparent failures of treatment, there’s not been any other published account [in the UK].”

All of the patients were eventually treated using other therapies.

But the detailed analysis of the parasites suggested they were developing ways of resisting the effects of the front-line drugs.

‘Clinically challenging’

Dr Sutherland added: “It does feel like something is changing, but we’re not yet in a crisis.

“It is an early sign and we need to take it quite seriously as it may be snowballing into something with greater impact.”

Two of the cases were associated with travel to Uganda, one with Angola and one with Liberia – suggesting drug-resistant malaria could be emerging over wide regions of the continent.

Dr Sutherland added: “There has been anecdotal evidence in Africa of treatment failure on a scale that is clinically challenging.

“We need to go in and look carefully at drug efficacy.”

The malaria parasites all seemed to be evolving different mechanisms rather than there being one new type of resistant malaria parasite spreading through the continent.

The type of resistance is also clearly distinct from the form developing in South East Asia that has been causing huge international concern.

Dr Sutherland says doctors in the UK need to be aware the drugs might not work and argued current treatment guidelines may need to be reviewed.

Prof David Lalloo, Dean of Clinical Sciences and International Public Health at Liverpool School of Tropical Medicine, said more studies are needed.

“This is an interesting and well conducted study and again emphasises the incredible ability of the malaria parasite to rapidly evolve to become resistant to antimalarial treatment,” he said.

“It is too early to fully evaluate the significance of these findings but the paper highlights the need to be constantly vigilant when treating patients with malaria and larger studies are certainly needed to explore this issue further.”

Prof Dame Sally Davies, the chief medical officer for England, said: “This is a stark warning for the future of global medicine.

“We are in dire need of new drugs to keep pace with resistance, in low and middle-income countries in particular, the consequences of ineffective drugs are catastrophic.”

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Stay Healthy & Protect Yourself from Cancer

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Health they say is wealth and there are certain habits that can guarantee great health even as you progress in years.
Eight healthy behaviors can go a long way toward improving your health and lowering your risk of many cancers as well as heart disease, stroke, diabetes, and osteoporosis. And they’re not as complicated as you might think.
So take control of your health, and encourage your family to do the same. Choose one or two of the behaviors below to start with. Once you’ve got those down, move on to the others.
1. Maintain a Healthy Weight
Keeping your weight in check is often easier said than done, but a few simple tips can help. First off, if you’re overweight, focus initially on not gaining any more weight. This by itself can improve your health. Then, when you’re ready, try to take off some extra pounds for an even greater health boost. To see where you fall on the weight range, click here.
Tips
  • Integrate physical activity and movement into your life.
  • Eat a diet rich in fruits, vegetables and whole grains.
  • Choose smaller portions and eat more slowly.
For Parents and Grandparents 
  • Limit children’s TV and computer time.
  • Encourage healthy snacking on fruits and vegetables.
  • Encourage activity during free time.
2. Exercise Regularly
Few things are as good for you as regular physical activity. While it can be hard to find the time, it’s important to fit in at least 30 minutes of activity every day. More is even better, but any amount is better than none.
Tips 
  • Choose activities you enjoy. Many things count as exercise, including walking, gardening and dancing.
  • Make exercise a habit by setting aside the same time for it each day. Try going to the gym at lunchtime or taking a walk regularly after dinner.
  • Stay motivated by exercising with someone.
For Parents and Grandparents 
  • Play active games with your kids regularly and go on family walks and bike rides when the weather allows.
  • Encourage children to play outside (when it’s safe) and to take part in organized activities, including soccer, gymnastics and dancing.
  • Walk with your kids to school in the morning. It’s great exercise for everyone.
3. Don’t Smoke
You’ve heard it before: If you smoke, quitting is absolutely the best thing you can do for your health. Yes, it’s hard, but it’s also far from impossible. More than 1,000 Americans stop for good every day.
Tips 
  • Keep trying! It often takes six or seven tries before you quit for good.
  • Talk to a health-care provider for help.
  • Join a quit-smoking program. Your workplace or health plan may offer one.
For Parents and Grandparents
  • Try to quit as soon as possible. If you smoke, your children will be more likely to smoke.
  • Don’t smoke in the house or car. If kids breathe in your smoke, they may have a higher risk of breathing problems and lung cancer.
  • When appropriate, talk to your kids about the dangers of smoking and chewing tobacco. A health-care professional or school counselor can help.
4. Eat a Healthy Diet
Despite confusing news reports, the basics of healthy eating are actually quite straightforward. You should focus on fruits, vegetables and whole grains and keep red meat to a minimum. It’s also important to cut back on bad fats (saturated and trans fats) and choose healthy fats (polyunsaturated and monounsaturated fats) more often. Taking a multivitamin with folate every day is a great nutrition insurance policy.
Tips
  • Make fruits and vegetables a part of every meal. Put fruit on your cereal. Eat vegetables as a snack.
  • Choose chicken, fish or beans instead of red meat.
  • Choose whole-grain cereal, brown rice and whole-wheat bread over their more refined counterparts.
  • Choose dishes made with olive or canola oil, which are high in healthy fats.
  • Cut back on fast food and store-bought snacks (like cookies), which are high in bad fats.
  • Buy a 100 percent RDA multivitamin that contains folate.
5. Drink Alcohol Only in Moderation, If at All
Moderate drinking is good for the heart, as many people already know, but it can also increase the risk of cancer. If you don’t drink, don’t feel that you need to start. If you already drink moderately (less than one drink a day for women, less than two drinks a day for men), there’s probably no reason to stop. People who drink more, though, should cut back.
Tips
  • Choose nonalcoholic beverages at meals and parties.
  • Avoid occasions centered around alcohol.
  • Talk to a health-care professional if you feel you have a problem with alcohol.
For Parents and Grandparents
  • Avoid making alcohol an essential part of family gatherings.
  • When appropriate, discuss the dangers of drug and alcohol abuse with children. A health-care professional or school counselor can help.
6. Protect Yourself from the Sun
While the warm sun is certainly inviting, too much exposure to it can lead to skin cancer, including serious melanoma. Skin damage starts early in childhood, so it’s especially important to protect children.
Tips
  • Steer clear of direct sunlight between 10 a.m. and 4 p.m. (peak burning hours). It’s the best way to protect yourself.
  • Wear hats, long-sleeve shirts and sunscreens with SPF15 or higher.
  • Don’t use sun lamps or tanning booths. Try self-tanning creams instead.
For Parents and Grandparents 
  • Buy tinted sunscreen so you can see if you’ve missed any spots on a fidgety child.
  • Set a good example for children by also protecting yourself with clothing, shade and sunscreen.
7. Protect Yourself From Sexually Transmitted Infections
Among other problems, sexually transmitted infections – like human papillomavirus (HPV) – are linked to a number of different cancers. Protecting yourself from these infections can lower your risk.
Tips
  • Aside from not having sex, the best protection is to be in a committed, monogamous relationship with someone who does not have a sexually transmitted infection.
  • For all other situations, be sure to always use a condom and follow other safe-sex practices.
  • Never rely on your partner to have a condom. Always be prepared.
For Parents and Grandparents
  • When appropriate, discuss with children the importance of abstinence and safe sex. A health-care professional or school counselor can help.
  • Vaccinate girls and young women as well as boys and young men against HPV. Talk to a health professional for more information.
8. Get Screening Tests
There are a number of important screening tests that can help protect against cancer. Some of these tests find cancer early when they are most treatable, while others can actually help keep cancer from developing in the first place. For colorectal cancer alone, regular screening could save over 30,000 lives each year. That’s three times the number of people killed by drunk drivers in the United States in all of 2011. Talk to a health care professional about which tests you should have and when.
Cancers that should be tested for regularly:
  • Colon and rectal cancer
  • Breast cancer
  • Cervical cancer
  • Lung cancer (in current or past heavy smokers)

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Health & Lifestyle

Sickle cell may get solution soon – scientists.

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Scientists in the U.S. have unveiled results of a small clinical trial that could mean an effective “cure” for sickle cell anemia, the painful and debilitating disease that inflicts many millions of people across the globe, mostly of African heritage and including some 100,000 African Americans in the U.S.



Researchers at the National Institutes of Health (NIH) say they have used gene therapy techniques to add a “corrected” gene for healthy red blood cells into the bodies of nine test patients, replacing their diseased red blood cells caused by sickle cell anemia and effectively ridding them of signs of the disease.

NIH Director Francis Collins described the trial results as seemingly “spectacular”.

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“When you look at their blood counts and their blood smears, it looks like they don’t have it anymore,” Collins said on Monday (March 11) from his office at the NIH in Bethesda, Maryland, just outside Washington, D.C.

Sickle cell disease is an inherited blood disorder that causes protein crystals to form inside red blood cells, changing their shape from a flat disk into a crescent or sickle shape that then clogs up the small blood vessels and results in terrible episodes of pain and organ damage.

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But they believe the basic premise of introducing a corrected gene into the body holds promise for Africa provided a simpler, cheaper and less toxic delivery system than bone marrow transplant and the accompanying chemotherapy can be found.

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