Malaria is a mosquito-borne disease caused by the parasite Plasmodium falicparum. Malaria is very prominent in sub-Saharan African and South Asian countries but is spread to the United States primarily by travelers that have visited these areas. Typical signs and symptoms of malaria include patients that experience a cycle of fever, chills, and sweating with feeling healthy in between the “attacks.” There are preventative measures for people that plan to travel to countries where malaria is prominent which includes antimalarial drugs, avoiding mosquito bites with the use of insect repellents, or using insecticide treated bed nets. Some of the medications used as preventative measures include chloroquine phosphate, doxycycline prophylaxis, or the combination of atovaquone and proguanil. While these drugs provide a greater chance for not contracting malaria, they are not 100% effective which can be attributed to the increasing resistance to medications by P. falciparum.
Treating Malaria
The most effective treatment against malaria is artemisinin-based combination therapies (ACTs) which was developed in the 1990s. The combination of this treatment with rapid testing of malaria and increased push for insecticide treated bed nets decreased the global mortality rate by 30% between 2010 and 2015. During the 1990s, nearly 1 million deaths occurred every year from malaria and now only 400,000 of 220 million cases per year result in death.
Drug Resistant P. falciparum
The first widely used antimalarial drug made was chloroquine which developed resistance in South Asian countries just after WWII. These resistant strains quickly spread to Africa which holds the highest malaria problem of the world. Not only has malaria developed resistance against preventative measures, but partial resistance against ACTs have also developed. This was first seen in 2007 in South Asian populations where artemisinin began taking much longer to clear the parasite from patients. There are currently no other viable options for treating malaria so this presents a major threat, especially if resistant strains spread to Africa. While some worry about this threat, others believe this threat receives too much attention and is not actually a serious problem right now. For example, Steve Meshnick, a professor of epidemiology at the University of North Carolina at Chapel Hill, agrees that partial artemisinin resistance is, for now, a mere blip in the fight against malaria. “I’m not saying it’s not a problem,” he says, “but I think it gets too much attention.”
Personal thought, it is not surprising that P. falciparum is developing resistance to the drugs that treat it because just about every bug that causes diseases today is developing resistance. While right now this developing resistance may not pose a urgent threat, I do think this deserves attention and that efforts towards fighting malaria need to strengthen in the chance that resistance spreads to Africa, which it probably will eventually. New options for treating malaria need to be developed so that we have backup options.
Vaccine Culture 