Best way to treat malaria: Avoid using same drug for everyone, scie...(and highly effective antimalarials that ...)

Some 350 to 500 million people are infected with malaria every year by being bitten by a mosquito carrying one of the four human malaria parasites, P. falciparum, P. vivax, P. malaria or P. ovale, according to statistics maintained by the World Health Organization. Falciparum infections are by far the most common, killing more than 1 million people each year. Malaria also contributes indirectly to many more deaths, mainly in young children, among those already suffering from other infections and illnesses. About 60 percent of the cases of malaria worldwide and more than 80 percent of malaria deaths occur in sub-Saharan Africa.

Boni, a mathematician as well as an evolutionary biologist, and his co-authors, Ramanan Laxminarayan and David Smith, designed a computer model with inputs based on more than 100 years of malaria field research. They simulated dozens of treatment paths for a malaria outbreak among patients contrasting many variations of the status quo strategy of using a single first-line therapy with one employing MFT.

They found there were major benefits to employing an MFT strategy, namely, fewer cases of malaria, fewer unsuccessful drug treatments, and a very significant delay in the onset of drug resistance in the parasites. As parasite resistance to antimalarial drugs is the key factor that can make drugs obsolete and useless, delaying and slowing down the evolution of drug-resistance is often viewed as a public health priority when designing strategies for eliminating or controlling malaria.

The computerized analysis conducted by the team represents the most extensive look yet at the question of what works best for large-scale and long-term malaria control. Boni, whose research focuses on the public health consequences of the evolution of infectious diseases, said their study was largely influenced by the work of the theoretical ecologist Simon
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