Science-- there's something for everyone

Sunday, November 14, 2010

Improved malaria treatment

An international team of scientists and doctors, lead by Nick White of the Wellcome Trust-Mahidol University-Oxford Tropical Medicine Research Programme in Bangkok, has conducted one of the largest clinical studies ever done on malarial patients. They found that the drug quinine should be replaced whenever possible by a drug called artesunate.

This is interesting for a two reasons. First, this breakthrough gives us an important advantage in the battle against a millennium-old foe. Malaria (a mosquito-born illness) kills almost a million people each year, mostly pregnant women and young children. Artesunate was found to decrease the malarial death rate by 22% when compared with quinine. In addition, fewer side affects were experienced by patients receiving artesunate, including fewer comas and seizures.

The second point I’d like to make is that this is how science is supposed to work. Quinine and artesunate are both nominally herbal remedies. Quinine is derived from Cinchona tree bark and artesunate is derived from an herb called qinghao (Artemisia annua), shown here. Quinine had been the malarial treatment of choice for centuries when qinghao was first proposed as a malaria treatment. Although researchers were skeptical at first, they proceeded to test artesunate, culminating in the enormous African Quinine v. Artesunate Malaria Trial (AQUAMAT) just completed. Without this sort of rigorous comparison, doctors would still be prescribing quinine for their malarial patients.

Even with artesunate, the death rate is still 8.5%, so there is plenty of room for improvement. The next drug candidates should now be tested against artesunate, rather than quinine.

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