Treatment of Malaria

The malaria is an intracellular protozoan infection, endemic in tropical and subtropical countries. Large number of drugs are being used worldwide for the treatment of malaria. Four species of the protozoal parasite Plasmodium cause all infections in human beings and these are: Plasmodium vivax, Plasmodium malariae, Plasmodium ovale and Plasmodium falciparum. The effectiveness of the antimalarial drugs may differ with the species and stage of parasite and the parasite load in the liver and blood circulation. The parasites are inoculated into the human host by blood sucking female anopheline mosquitoes. The sporozoites from the infected mosquito reach the liver and develop into tissue schizonts. These tissue schizonts then rupture, form free merozoites and invade erythrocytes or red blood cells (RBCs) and develop as erythrocytic schizonts and lead to rupture of RBCs. There are different groups of antimalarial drugs for the stages of malarial parasites in the liver and erythrocytes.

Chloroquine (4-aminoquinoline) has been used extensively for the treatment and prevention of malaria. It has considerable efficacy for the treatment of Plasmodium vivax, Plasmodium malariae and Plasmodium ovale infections, however, widespread resistance has been seen against Plasmodium falciparum infection. Effective suppressive prophylaxis has been documented with chloroquine, mefloquine, proguanil and doxycycline as these are schizonticidal drugs. Proguanil and primaquine are best known for causal prophylaxis as these drugs effectively kill the hepatic stages of the parasite. Quinine, chloroquine, primaquine and artemisnins are established gametocidal drugs also. Sulfonamides (sulfadoxine and dapsone) and aminoalcohols (halofantrine and lumefantrine) are also used in the treatment of malaria but are more toxic drugs. The drug toxicity may lead to acute hemolytic anemia in patients with glucose-6-phosphate dehydrogenase (G6PD)deficiency. Consult your physician for the diagnosis and treatment of malaria.