WORLD's MOST DEVASTATING PARASITIC INFECTION (CLINICAL RESEARCH ORIENTED )

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Malaria is the world's most devastating human parasitic infection. It is estimated that the disease kills an African child every seconds. Other high - risk groups include refugee, visitors and laborers from non - endemic regions . It afflicts about 500 million people and cause causes 2 million deaths per annum . Most susceptible are children younger than five years , pregnant women, and non - immune individuals . More than 90% of this death occur in sub - Saharan Africa. With an estimated 100 million cases and 100,000 deaths each year. Nigeria is the country with the highest number of malaria casualties worldwide. In Nigeria as at April ,2015, malaria was responsible for 60% out - patient visit to health facilities , 30% of childhood deaths , 25% of deaths in children under one year and 11% of all maternal deaths . Malaria imposes a huge economic burden on countries where the disease is life.
half of the total world population is exposed to the risk of contracting malaria.

Malaria is an infectious disease caused by a parasite that is transmitted by some mosquitoes. It is widespread in tropical regions, where it kills several million people every year.
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Life cycle of the malaria parasite illustrating the various stages that are relevant to vaccine design. These are (1) the anopheline mosquito vector, used in experimental protocols to immunize with irradiated sporozoites administered by mosquito bite; (2) the sporozoite, the target of several vaccines, including RTS,S; (3) the liver-stage, usually targeted by vectored vaccines; (4) the blood-stage, usually targeted by protein in adjuvant vaccine candidates. Merozoite antigens have been most often included in blood-stage vaccines; (5) the gametocyte which along with the ookinete, formed after fertilization in the mosquito midgut, is the source of parasite antigens used in sexual-stage transmission-blocking vaccines. Pre-erythrocytic vaccines, which target the sporozoite and the liver-stage parasite are intended to prevent infection as well as disease while blood-stage vaccines are intended to prevent clinical illness and death.
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PREVENTION

Methods used to prevent malaria include medications like intermittent preventive therapy ( IPT) often consists of a combination of Sulfadoxine and Pyrimethamine.
Other preventive methods include vector control efforts such as Indoor Residual Spraying (IRS ), decreasing the availability of stagnant bodies of open water and health education . The use of insect repellents containing picardin or DEET ( N.N - Diethyl - ether toluamide ) is on the rise now as infections from othe species gain traction e.g Zika virus disease from Aedes egypti mosquito ). Sleeping under LLIN ( Long - lasting insecticide treated Nets ) is a very effective way of preventing malaria . RTSS is a vaccine that has been developed by GlazoSmithKline Biologicals , Malaria accine Initiative ( MVI ) , Bill & Melinda Gates foundation and a network of African research centers . It is the first malaria vaccine to have completed pivotal phase 3 trial and obtained a positive scientific opinion by EMA (European Medicines Agency ) . RTS' S or Mosquirix® was shown to offer the best protection among children age 5 - 17 months who received three dozes of the vaccine a month apart , plus a booster dose at 20 months .

Malaria vaccine is a vaccine that is used to prevent malaria. The only approved vaccine as of 2015 is RTS,S. It requires four injections, and has a relatively low efficacy (26–50%). Due to low efficacy, WHO does not recommend the use of RTS,S vaccine in babies between 6 and 12 weeks of age.
malaria vaccine

The development of genetically modified mosquitoes is another new frontier in the war against malaria . Researchers in the US say they have bred a mosquito that can resist malaria infection and pas on the resistant gene to its offspring . Oxitec , a scientific firm in the UK have developed a breed of mosquitoes that serially reproduces only males. This they released into the wild by spring 2016 and thereby reduce the mosquito population.

TREATMENT

Malaria treatment has evolved over the last fifty years mainly due to the problem of drug resistance which has led to the abandonment of chloroquine , monotherapy , and early drug combinations like chloroquine + proguanil, pyrimethamine + Dapsone etc. Antimalarial are mostly classified today in terms of the action against the different stages of the life cycle of the parasitte.

DRUG USED TO TREAT THE ACUTE ATTACK

Blood schizonticidal agents are used to treat the acute attack but also produce a suppressive or clinical cure.
They act on the erythrocytic form s of plasmodium . In the case of the p. falciparum and P. malariae who have no exoerythrocytic stage , these drugs affect a cure. However, with and P. Ovale and P. Vivax, they only suppress symptoms before recrudesecence occurs . This group of drug includes .
• Quinoline - methanols like Quinine & Mefloquine
• 4 - Aminoquinoline like chloroquine & Amodiaquine
• Antifolate drugs like pyrimethamine & Dapsone
• Atovaquone
• The new mepacrine - like drug , pyronaridine.

DRUGS THAT AFFECT A RADICAL CURE

Tissues schizonticides are able to eradicate even P. vivax & P. Ovale parasite in the liver . Primaquine and tafenoquine , both 8 - aminoquinolines are the only drugs known to have such ability . these drugs also destroy gametocytes and so reduce the spread of infection .

CASUAL PROPHYLACTICS

These drugs block the links between the exoerythrocytic stage and the erythrocytic stage and thus prevent infections from becoming attacks . Drugs in this class include lumefantrine , proguanil , pyrimethamine , mefloquine.

DRUGS USED TO PREVENT
TRANSMISSION

These agents can destroy gametocytes , preventing transmission by the mosquito and thus diminish the human reservoir of the disease. e.g Primaquine , proguanil , & pyrimethamine.
Conclusion: malaria disease is worldwide in distribution but most affect the endemic region like Africa. Malaria parasite has shown resistance to early drugs which led to to invention of new anti -malaria drug all the time.

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