The Effectiveness of Different Solutions to Prevent or Treat Malaria

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Issue Report: The Effectiveness of Different Solutions to Prevent or Treat Malaria

Malaria is a mosquito-borne infectious disease commonly known in tropical and subtropical regions such as Sub Saharan, Africa, Asia and America.  It is a potentially fatal blood disease caused by protozoan parasites of the genus Plasmodium. There are four types of plasmodium parasite that can infect humans and these are:  Plasmodium falciparum and Plasmodium vivax, Plasmodium ovale and Plasmodium malariaecan.

Malaria parasites are transmitted successively infecting two types of hosts: Female Anopheles mosquitos and humans. This is how the Malaria Life Cycle works:

Bitten by a mosquito, during feeding, malaria parasites (sporozoites) leave the mosquito salivary gland and enter the human bloodstream. Then the malaria parasites enter the liver, infect the liver cells (hepatocytes) where they multiply into merozoites parasites. The liver cells eventually rupture and release more parasites in the blood. The parasites invade the red blood cells where they continue to multiply and develop to trophozoites and schizonts and rupture the cells. The blood stages cause the clinical symptoms of malaria. Some parasites enter the red blood cells and develop into male and female reproductive cells (termed gametocytes). The gametocytes are transferred to another mosquito when it feeds on the human. Then the phase of sexual reproduction continues in the mosquito. In the mosquito’s gut the male cell fertilizes the female cell to form a zygote. Then the zygote enlarges and migrates to the outer wall of the gut. There the parasites multiply several times and then released. Te parasites then migrate to the mosquito’s salivary gland. The parasites accumulate in the salivary glands, ready for transfer to another human. When the mosquito bites another human, the parasites leave the mosquito salivary gland and enter the human bloodstream.


  • Fever
  • Shivering
  • arthralgia (joint pain)
  • vomiting
  • anemia (caused by hemolysis)
  • Jaundice
  • hemoglobinuria 
  • retinal damage convulsions.


Now, in the 21st century no 100% treatment against malaria is available. But the most common ways to treat malaria is through Antimalarial drugs which are used in order to prevent or cure malaria. Such drugs may be used for some or all of the following:

  • Treatment of malaria in individuals with suspected or confirmed infection
  • Prevention of infection in individuals visiting a malaria-endemic region who have no immunity (malaria prophylaxis)
  • Routine intermittent treatment of certain groups in endemic regions  (intermittent preventive therapy)

Quinine is the standard anti-malarial and the first effective treatment in drug in the management of severe forms of malaria. It is an alkaloid extracted from guanine bark. The drug works to slow down the parasites' heme polymerase, the enzyme that polymerizes toxic heme to hemozoin. Toxic free heme builds up in the parasites, leading to their death. Quinine hunts for the pathogen and kills the organism causing the disease. Also it may cause an elevation in the pH of the pathogen, affecting the acidity of its cellular biology. But as most of the drugs Quinine also has side effects such as Convulsions at high doses (during injections), vomiting and Hypoglycaemia.

Chloroquine has long been used in the treatment or prevention of malaria and until recently was the most widely used anti-malarial. Chloroquine is a complicated compound with still an unclear way of how it works. What do we know is that inside the red blood cells, the malaria parasite must corrupt the hemoglobin for the gaining of essential amino acids, which the parasite requires to construct its own protein and for energy metabolism which is essential for it to grow. Chloroquine raises the pH inside parasite’s acidic vacuole. Chloroquine then binds to heme forming a complex which is highly toxic thus leading to disrupt membrane function and cause death.

This table shows the different derivatives that exist, due to different efficacy levels, of quinine and chloroquinine such as mefloquinine and amodiaquine.

Also it shows how efficient they are and if they are expensive or not.

Drug resistance has been defined to be the ability of the parasite to survive and withstand the drug to which they were once sensitive and were once slowed in growth or killed outright. Either the drug is poor, poor absorption, misdiagnosis and incorrect doses being given or drug resistance parasites lead to malaria treatment failure. Nearly all anti-malarial drugs have a drugs resistance parasite out of the four plasmodium species. This is because in different regions the drugs acts differently on each plasmodium species, therefore there are derivatives for each drug. For example quinine is especially useful in areas where there is known to be a high level of resistance to chloroquine,mefloquine, and sulfa drug combinations with pyrimethamine. Quinine is less effective and more toxic as a blood schizonticidal agent than chloroquine; however, it is still very effective and widely used in the treatment of acute cases of severe P. falciparum.  Chloroquine being the cheapest, the best tested and the safest of all existing drugs, has been used all over the world leading to malaria parasite Plasmodium falciparum to develop a widespread resistance to it. Now, new potential uses of this drug have been investigated.

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This table displays some of the drugs that face drug resistance. Some of those have been reported so derivatives can be used instead. In addition in the table the fact that every drug has side effects shows that the treatment has to be controlled and any other information about something that could cause a side effect such as receiving any other drug, for example a painkiller, should be notified to the doctor.

As stated by the journal of Nicholas J.White:“Resistance has emerged to all classes of antimalarial drugs except the artemisinins and is responsible for a recent increase ...

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**** This report contains a great deal of technical detail and appropriate A level biological terminology. A little more background information about the distribution of the disease, differences in mortality and how these are linked to particular Plasmodium species would be useful. The issue of resistance is complex but it would, perhaps, have been useful to attempt a global overview of where resistance to particular drugs / drug combinations by particular Plasmodium species is greatest.