Gabon researchers test promising single-dose malaria treatment
Global Health Breakthrough: Single-Dose Malaria Treatment Offers Hope Against Drug Resistance in Endemic Regions Researchers in Gabon have achieved a significant milestone in malaria control with a novel single-dose treatment that demonstrates efficacy comparable to standard multi-day regimens, potentially transforming management of the disease in high-transmission areas world wide. The clinical trial, led by Dr. Ghyslain Mombo-Ngoma at the Medical Research Centre of Lambaréné (CERMEL), evaluated a fixed-dose combination of four well-established antimalarial compounds: sulfadoxine, pyrimethamine, artesunate, and pyronaridine. Administered as a one-time oral therapy, the regimen successfully cleared Plasmodium parasites from the bloodstream in 93% of participants within 28 days—matching the cure rate of the World Health Organization-recommended three-day artemisinin-based combination therapy (ACT).“This is not a new drug discovery, but a strategic repurposing of existing, affordable medicines,” Dr. Mombo-Ngoma explained. “With Plasmodium falciparum developing partial resistance to artemisinin derivatives across Southeast Asia and emerging reports in Africa, we urgently need alternatives that preserve treatment efficacy without requiring complex supply chains or prolonged patient follow-up.”The study enrolled patients across urban and rural sites in Gabon, reflecting real-world conditions in sub-Saharan Africa, where malaria accounts for approximately 94% of global cases and deaths. Gabon’s 2024 surveillance data from the National Malaria Control Program documented over 154,000 confirmed infections, with children under five comprising the majority of severe cases and fatalities. Program director Hugues Ronel Essanga Ngomo described malaria as “a leading cause of childhood mortality and a persistent barrier to socioeconomic development.”Patient adherence remains a critical challenge in malaria-endemic settings. Multi-day treatments often see completion rates below 60% due to logistical barriers, cost, side effects, or symptom resolution after initial doses—creating selective pressure that accelerates drug resistance. A single-dose option addresses these gaps directly.Libreville resident Julicia Nfono, a mother of three who has experienced recurrent malaria, highlighted the daily burden: “We sleep under insecticide-treated nets, eliminate standing water, and take every precaution, yet the disease returns with the rains. A treatment that works in one visit would change everything for families like mine.”Beyond compliance, the four-drug synergy targets multiple parasite metabolic pathways simultaneously, reducing the likelihood of resistance emergence. Pyronaridine, a longer-acting partner drug, provides post-treatment prophylaxis for up to 42 days, potentially lowering reinfection rates in high-transmission zones.The WHO’s 2024 World Malaria Report warns that global progress against the disease has stalled, with 249 million cases and 608,000 deaths recorded in 2023—figures largely unchanged since 2015. Partial artemisinin resistance now confirmed in Rwanda, Uganda, and Eritrea underscores the urgency of diversified therapeutic strategies.While regulatory approval and large-scale production remain pending, the Gabon trial—published in a forthcoming peer-reviewed journal—has drawn attention from the Global Fund, African Medicines Agency, and Medicines for Malaria Venture. Pilot implementation studies are being planned in the Democratic Republic of Congo and Nigeria.If validated at scale, the single-dose regimen could integrate into seasonal malaria chemoprevention campaigns, mass drug administration efforts, and routine outpatient care—delivering a cost-effective, resistance-mitigating tool to the world’s most vulnerable populations.
