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New treatment for liver parasites in vivax malaria

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(Vienna, 21 January 2019) Vivax malaria is a serious illness with high fever that, if untreated, can keep people bed-ridden for weeks or even months. But even after successful treatment, it's tricky: although the current, commonly-used drugs successfully treat the blood stage of vivax malaria, they are unable to prevent malaria parasites from invading the liver (liver stage) and causing the disease to recur repeatedly over many years. An international, multi-centre research group with major participation from MedUni Vienna has now shown in a Phase 3 trial that a single dose of the drug Tafenoquine is enough to prevent this "Trojan horse" from establishing itself in the liver.

The results of the trial have now been published in the leading "New England Journal of Medicine“ (impact factor 72.406). Harald Nödl is co-author of the study, he was involved at MedUni Vienna's Institute of Specific Prophylaxis and Tropical Medicine. The trial was conducted, inter alia, as part of a close collaboration between MedUni Vienna and hospitals in Gondar und Jimma in Ethiopia, where two new research centres supported by MedUni Vienna were recently opened.

"It's important that the treatment only comprises a single dose," emphasises Nödl. "Although effective medicines were available, they had to be taken daily for 14 days after the end of the actual malaria attack. There is a lack of discipline when it comes to taking the medicine. Therefore, in most cases, the illness keeps recurring over many years."

Plasmodium vivax, the underestimated parasite – gaining in significance
In large parts of Asia and South America, vivax malaria is already the commonest form of malaria. In Africa, on the other hand, it is exclusively the countries on the Horn of Africa, in particular Ethiopia, that are affected by it.  In Ethiopia alone there are hundreds of thousands of cases a year. Although vivax malaria is rarely fatal in itself, it plays a significant role in the cycle of poverty and disease... and it's on the increase. The drug that has now been trialled and will presumably be available for clinical use in the near future, now provides "real hope that one day we will be able to eradicate vivax malaria in many countries. This is a huge opportunity," stresses Nödl.

Service: New England Journal of Medicine
„Single-Dose Tafenoquine to Prevent Relapse of Plasmodium vivax Malaria.” Marcus V.G. Lacerda, H. Noedl, Rezika Mohammed, Ermias Diro,  Sisay Getie, Kalehiwot M. Wubie, Justin A. Green, Gavin C.K.W. Koh et al. DOI: 10.1056/NEJMoa1710775.