Drug resistance in plasmodium, future malaria management strategies and importance of medicinal plants

Abstract

Malaria, the most common and destructive parasite disease in humans, take the lives of 1-2 million people every year. With the exception of artemisinin, resistance to most of the existing antimalarial agent classes has arisen, resulting in a new spike in malaria-related mortality, particularly in Africa. Southeast Asia has been a focal point for the development of drug resistance in Plasmodium falciparum since the late 1950s, when the first example of chloroquine resistance was discovered along the Thai-Combodian border. Despite the fact that the first incidence of quinine resistance had been documented far earlier in South America, the emergence of chloroquine resistance in Southeast Asia signalled the beginning of a new era in malaria history. Following the development of chloroquine resistance, Thailand and African countries shifted to a sulphadoxine-pyrimethamine combination as their first-line medication (SP). SP was subsequently superseded by mefloquine. Because of the quick development of resistance to this new medicine, artemisinin was introduced as a combination drug in the mid-1990s. Artimisinin resistance has been identified in several parts of the world, and if it continues, malaria control initiatives could be jeopardised, as there is now no substitute antimalarial medicine available. The purpose of this review is to summarise the current state of knowledge about drug-resistant malaria and to sketch out the evolving trends of resistance to antibiotics, such as its causal factors, current situation in various geographical areas, molecular markers, consequences for preventing the emergence and spread of drugresistant malaria, and the role of medicinal plants in the discovery of novel antimalarials.