Malaria fight to tackle parasites

Malaria fight to tackle parasites

Health Ministry officials say Thailand is now shifting its strategy in the fight against malaria, turning from focusing on efforts to control the disease to trying to eliminate it altogether.

Jeeraphat Sirichaisinthop, a senior expert at the Department of Disease Control (DDC), said the country has been successful in controlling malaria and the number of cases has sharply decreased over the past several decades. The next stage is to begin eliminating the parasites, which are transmitted by mosquitoes.

But one of the biggest hurdles will be combating the growing number of drug-resistant malaria strains, said Mr Jeeraphat, speaking on the sidelines of a forum on malaria control hosted by France Expertise Internationale, the French international development agency.

Mr Jeeraphat said there are now fewer than 100 malaria deaths per year in Thailand, whereas 50 years ago there were more than 10,000 mortal cases annually.

Despite better treatment for malaria infections, authorities must monitor outbreaks to ensure no new cases arise and progressively reduce the number of zones with recurrence risks.

"If we want to permanently eliminate malaria, we must prevent new infections,'' he said.

Mr Jeeraphat said extensive, large-scale tests will be needed in malaria-prone provinces to root out existing cases. These include patients who are infected with parasites but show no symptoms of the disease yet.

François Nosten, a researcher at Oxford University and director of the Shoklo Malaria Research Unit in Mae Sot, Tak province, said 80% of parasites infecting people along the Thai-Myanmar border have become resistant to anti-malaria medicine. The resistance rate has increased sharply since 2003.

The Global Fund To Fight Aids, Tuberculosis and Malaria has allocated US$10 million (33 million baht) to finance Thailand's fight against drug-resistant malaria over the next two years.

Aligning itself with World Health Organisation recommendations, the Global Fund is seeking to administer anti-parasite drugs to entire populations living in infected areas, which Mr Nosten said is important to do before the medicine becomes obsolete.

But Mr Jeeraphat believed mass drug administration is unlikely to be successful in Thailand because there is so much cross-border movement among the migrant labour force.

Wichai Satimai, a DDC adviser, said the provinces are unlikely to get sufficient community buy-in.

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