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The International Journal of the Royal Society of Thailand
Volume XI - 2019

Recent research of Mahidol University related to malaria control

The Faculty of Tropical Medicine, Mahidol University has conducted
clinical and public health research, focusing on novel tools and measures for
malaria elimination. This review describes recently published research in malaria
elimination and is categorized as: (1) effective treatment, (2) containment of

artemisinin-resistant malaria, and (3) malaria prevention in the community. This
work by Mahidol University will support the ongoing strategies for malaria
eradication in Thailand and other countries.

Effective treatment
Timely treatment of malaria with effective drugs is the most important
measure to save lives, cure the infection, and prevent the spread of malaria,

which is critical in multi-drug resistant areas such as Thailand. The latest
occurrence of P. falciparum resistant to artemisinin and artemisinin-based
combination therapy (ACT) is a threat to global malaria control. Malaria parasites,
especially P. falciparum, have been evolving to become resistant to most antimalarial
drugs. It is, therefore, essential to monitor drug resistance and updated effective
treatment (Pukritayakamee et al, 2000, 2004, 2008, 2010, 2014). While waiting
for new antimalarial drugs, combinations of existing antimalarial drugs, based
on pharmacokinetic half time and mechanism of actions, have been successful
considerably in keeping pace with the spread drug-resistant P. falciparum strains.

Malaria infection is a disease of poor and developing countries and
antimalarial therapies are considered orphan drug unlikely to generate high
returns on investment. Since artemisinin drugs became widely available 30 years
ago, very few new antimalarial drugs have become available for Phase I or II
clinical trials. The FACULTY OF TROPICAL MEDICINE was given the opportunity
in 2013-2016 to assess the efficacy of three new novel drugs in patients with acute
malaria in phase II trials. These drugs, KAE609, KAF156, and OZ439 have potential
advantages over artesunate. OZ439 has a longer half-life, KAE and KAF have
entirely different chemical structures and have more stage specificity compare
to artemisinin drugs. The trials found that all 3 drugs are safe and effective for
falciparum and vivax malaria and are effective against multi-drug resistant
parasites (White & Pukrittayakamee et al, 2014, White et al, 2016, Phyo et al, 2016).

The WHO has listed all these 3 drugs in the 2015 innovative pipeline (Figure 3)
for antimalarial drug development as the drug resistance is likely to increase.

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Sasithon Pukrittayakamee et al.

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