Abstract

Malaria affects millions of people annually, especially in third-world countries. The mainstay of treatment is oral anti-malarial drugs and vaccination. An increase in resistant strains of malaria parasites to most of the current anti-malarial drugs adds to the global burden. Moreover, existing and new anti-malarial drugs are hampered by significantly poor aqueous solubility and low permeability, resulting in low oral bioavailability and patient noncompliance. Lipid formulations are commonly used to increase solubility and efficacy and decrease toxicity. The present review discusses the findings from studies focusing on specialised oral lipophilic drug delivery systems, including self-emulsifying drug delivery systems (SEDDSs). SEDDSs facilitate the spontaneous formation of liquid emulsions that effectively solubilise the incorporated drugs into the gastrointestinal tract and thereby improve the absorption of poorly-soluble anti-malaria drugs. However, traditional SEDDSs are normally in liquid dosage forms, which are delivered orally to the site of absorption, and are hampered by poor stability. This paper discusses novel solidification techniques that can easily and economically be up-scaled due to already existing industrial equipment that could be utilised. This method could, furthermore, improve product stability and patient compliance. The possible impact that solid oral SEDDSs can play in the fight against malaria is highlighted.

Highlights

  • Malaria affects millions of people annually, especially in third-world countries

  • According to the World Health Organization’s (WHO) malaria report, a projected 229 million cases of malaria occurred internationally in 2019, with the WHO African Region accounting for 94% of all malaria deaths

  • This work demonstrates that numerous issues can be resolved, utilising well-established oral drug delivery systems that are applied in a novel manner; i.e., the successful utilization of solidified self-emulsifying drug delivery systems (SEDDSs), which could potentially significantly improve current malarial treatment regimens, ensuring increased patient compliance in especially poverty-stricken regions, without increasing the economic burden of patients

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Summary

The Perpetual Battle with Malaria

Despite intensive efforts to control malaria, it remains a devastating global challenge. Pharmaceuticals 2022, 15, 120 defined as “Odyssean”,” mini-bus” or “baggage” malaria, has recently been documented This process allows the transmission of, especially, the P. falciparum parasite to non-endemic areas as a result of its ability to survive inside passengers’ baggage under favourable climatic conditions [5,6]. Povertyrelated diseases are the leading cause of death in children and adolescents and primarily affects low- and medium-income countries where they cause a significant burden on the population’s health and have a considerable negative impact on the already overwhelmed economic development Diseases such as malaria directly affect the most vulnerable populations—those with limited access to adequate health care services and acceptable nutritional diets—resulting in a notably persistent threat to global health [11]. This work demonstrates that numerous issues can be resolved, utilising well-established oral drug delivery systems that are applied in a novel manner; i.e., the successful utilization of solidified self-emulsifying drug delivery systems (SEDDSs), which could potentially significantly improve current malarial treatment regimens, ensuring increased patient compliance in especially poverty-stricken regions, without increasing the economic burden of patients

Treatment Regimens Currently Suggested for Uncomplicated Malaria
Why Fixed-Dose Combination Therapy
Facing Artemisinin-Based Combination Therapy Shortcomings
Lipid Formulations
Optimising Oral Lipophilic Drug Delivery through Natural Solubilisation
Solidification Techniques
Capsule Filling with Liquid and Semisolid SEDDS
Adsorption to Solid Carriers
Wet or Melt Granulation
Melt Extrusion or Extrusion-Spheronisation
Freeze-Drying
Spray-Drying
Spray-Congealing or Spray-Cooling
Supercritical Fluid-Based Methods
Findings
Solid Self-Emulsifying Drug Delivery Systems May Pose a Bright Future for the
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