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The results of more than four years' research involving almost 3,000 Papua New Guinean children aged from six months to five years - a collaborative effort between The University of Western Australia and the Papua New Guinea Institute of Medical Research - have been published in The New England Journal of Medicine.

Professor Tim Davis, of UWA's School of Medicine and Pharmacology, was a lead investigator in the team which carried out a state-of-the-art clinical trial to evaluate the safety, tolerability and efficacy of therapeutic options among young children exposed to two kinds of malaria.

"Falciparum malaria is the most serious and widespread form which, if untreated, can be fatal," Professor Davis observed.  "Vivax malaria, which is prevalent outside Africa with 2.6 billion people at risk, has been considered ‘benign'.  However, increasing evidence suggests that vivax malaria can also contribute to complications such as anaemia and even death.  Established drugs such as chloroquine and Fansidar are losing effectiveness against both forms of malaria."

Known as ‘the quiet catastrophe', malaria affects hundreds of millions of people every year and kills more than two million.  It claims the lives of three children every minute.  Children are particularly vulnerable as they have not had time to build immunity.  About 250,000 Australians visit malarious countries annually and there has been a corresponding increase in locally-reported cases.

Professor Davis and his team found that one drug combination (Coartem or Riamet), which is available in Australia and currently recommended by the World Health Organisation for first-line use in tropical countries, was the most effective against falciparum malaria in the children recruited to the study.  However, its activity against vivax malaria was poor.

A newer combination (Artekin or Duocotecxin) has been thought by some authorities to be a superior treatment.  While it was the best option for vivax malaria, it was far from fully effective and was disappointing against falciparum malaria.

The study highlights the importance of testing antimalarial treatments in groups of at-risk children in countries like Papua New Guinea before recommendations are made.  It also shows that malaria remains difficult to control in tropical countries.  The search for new combination therapies, especially those with good efficacy against vivax malaria, remains a high priority.

Media references

Professor Tim Davis (+61 8)  9431 3229
Janine MacDonald (UWA Public Affairs)  (+61 8)  6488 5563  /  (+61 4) 32 637 716