The War on Malaria: A New Arsenal
In 2011, the then WHO Director-General, Dr Margaret Chan, proclaimed, “The usefulness of our most potent weapon in treating malaria is now under threat.” Chan called out to researchers, funders, and policy leaders to recognize the urgency of artemisinin-resistant Plasmodium falciparum parasites, a formidable threat that jeopardizes the goal of malaria eradication.
Flash forward to 2018, it seems that a new discovery made by scientists at Radboud University Medical Center will counteract the wave of artemisinin resistance. Research shows that dye methylene blue safely eliminates malaria parasites at an unprecedented rate. Typically, when a person is bitten by a malaria-transmitting mosquito, single-celled malaria parasites enter the red blood cells. As the parasites nest inside the blood, they split into male and female sex cells called gametocytes. If another mosquito bites the person, it sucks up those gametocytes, fertilizing them in the process. Although artemisinin-based combination therapies serve as the one-stop solution to treating patients, these medicines do very little to stop the spread of the parasite. This is because the parasites remain in the patients blood for a long time, allowing other mosquitoes to be infected if they were to feed on the patient. Moreover, artemisinin-resistant parasites have even more robust proliferation mechanisms, further perpetuating the malaria cycle.
However, a new frontier has emerged: dye methylene blue, a chemical that is frequently bought in pet stores to fight fungal infections in tropical fish. Methylene blue has been found to eliminate all gametocytes in patients’ bloodstreams within an alarming 48-hour time period. On the contrary, patients who were not given dye had the capacity to infect other mosquitoes for at least a week. For now, the only catch to this dye seems to be its awkward side effect: bright blue urine.
This new discovery sparks new hope for the war against malaria. The dye could potentially have far-reaching consequences on communities that suffer from high malaria transmission rates despite efforts to distribute bed nets and rapid diagnostic tests. However, even with this discovery, the global health community must remain vigilant and stay on guard as there are still many avenues by which malaria can penetrate our health system. Namely, false-positive and false-negative diagnostic results continue to limit efforts to eradicate malaria.
As the saying goes: It ain’t over ‘till it’s over.