Country triggers plan to eliminate one of malaria’s main parasites

Publicação: 15 de September de 2015

The matter was discussed within the National Program of Malaria Control

The urge to eliminate P. falciparum is also due to the imminent risk of the parasite developing resistance to the drugs currently used in the world

The urge to eliminate P. falciparum is also due to the imminent risk of the parasite developing resistance to the drugs currently used in the world

The number of malaria cases has decreased in Brazil, especially in the Amazon. In Amazonas State, for example, the total of infected people dropped from 232 thousand in 2005 to 66.6 thousand last year. Yet still, such reduction demands some challenges, as maintaining the drop and, meanwhile, advance towards eliminating the disease from the Country, keeping the political commitment and necessary resources to combat the disease.

One of the ways to keep the progress against malaria is in course: a plan aiming to eliminate Plasmodium falciparum from the Country. Despite not being the main causative agent in Brazil – Plasmodium vivax is responsible for over 80% of the cases -, eradicating P. falciparum is fundamental for the malaria control strategy, according to Dr. Pedro Luiz Tauil, PhD. in Tropical Medicine.

The P. falciparum elimination was one of the main themes at the July meetings of the National Program for Malaria Control, from the Health Ministry’s Health Surveillance Secretary, that took place in the Fiocruz headquarter in the Federal District. The meetings were conducted in two of the Program’s committees. The first and broader deals with the initiative’s general aspects, while the latter is a subcommittee that deals with the disease’s therapy.

“We have achieved a significant reduction of P. falciparum, and despite in lower intensity, also the P. vivax. For this reason the proportion of the latter, in the country, is currently much greater than the first. We have had many benefits, since the falciparum causes a more severe illness than the vivax. This has drastically reduced the number of deaths and hospitalizations in Brazil”, explains Dr. Tauil. The need to eliminate the P. falciparum is also due to the imminent risk of the parasite developing resistance to the effective drugs currently in use in the world, which are the artemisinin derivatives.

According to the expert, in order to maintain the drop in the number of cases, Brazil must keep investing in adequate and appropriate malaria treatments and diagnostic, followed by a selective vector control. The main measure of this kind of control in the world is the use of mosquito nets impregnated with insecticide.

As for the therapy committee, the group stressed the need to search for new treatments for P. falciparum, due to the risk of the species developing resistances to the currently used drugs. “The group also recommended that when chemoprophylaxis for travelers is recommended [use of drugs to reduce the risk of infection], a product still not available in Brazil should be used: Maralone, an association of two drugs: Atovaquone and Proguanil”, affirmed Dr. Tauil.

With the ongoing discoveries, other actions against the parasite’s species could be furtherly used in Brazil. This is the case of a vaccine against P. falciparum. In July, the European Medicines Agency (EMAapproved this immunizer, but for exclusive use in babies from 6 weeks to 17 months. It is expected that the product may be available for use in 2017.

Other matters of the Malaria Program’s committees included a discussion about anti-malaria drugs and insecticides resistance – a theme that is approached along with research groups funded by the Health Ministry. Other considerations involved therapy schemes for pregnant women and children with P. vivax were redefined, the possible association of Artesunate and Mefloquine in endemic regions to treat P. falciparum and the use of intramuscular Artesunate instead of Athemeter.