CURIOUS CASE OF DRUG RESISTANT MALARIA AND ARTEMISININ COMPOUNDS IN THE MODERN ERA

Abstract

Malaria is caused by Plasmodium parasite, transmitted by the bite of infective female Anopheles mosquito. The four species causing human infections are P falciparum, P vivax, P malariae and P ovale. P falciparum causes the majority of infections and is main culprit for most severe disease and mortality. Whereas P. vivax and P. ovale form resting stages in the liver (hypnozoites), that once reactivated, can lead to a clinical relapse many months after the initial event. The effective treatment is now compounded by the spread of drug resistant strains of the parasite. As a result, traditional alkaloid drugs such as chloroquine and quinine are now largely ineffective. The spread of parasite resistance has led the World Health Organization (WHO) to predict that without new antimalarial drug intervention, the number of cases of malaria will definitely increase. The growing menace of drug resistance has greatly complicated the treatment for malaria. Whereas chloroquine and sulfadoxine/pyrimethamine could once cure most infections, this is no longer true and requires examination of alternative regimens for the treatment of malaria. Artemisinin-based combinations are now widely accepted as the best treatments for uncomplicated falciparum malaria. Such combination treatments are rapid and reliably effective. The efficacy of the treatment is determined by the drug partnering the artemisinin derivative and, for artesunate-mefloquine, artemether-lumefantrine, and dihydroartemisinin-piperaquine, this usually exceeds 95%. This paper unfolds resistance to various conventional antimalarials and brief outline about artemisinin derivatives.