Treatment

A malaria infection, particularly with the species P. falciparum, which is endemic in parts of Africa, requires immediate attention. Infants can die within 24 hours of contracting the disease. Malaria can be treated with one or a combination of the following medications:

  • Chloroquine
  • Quinine Sulfate
  • Hydroxychloroquine
  • Combination of Sulfadoxine and Pyrimethamine (SP)
  • Mefloquine
  • Combination of Atovaquone and Proguanil
  • Doxycycline

Which drug an infected person takes and length of treatment depends on age, the type of malaria, and where the person contracted the disease. Treatment can be oral or intravenous depending on the severity of illness.

Artemisinin-based Combination Therapies involve combining anti-malarial drugs with artimisinin derivatives, which come from raw extracts from the plant Artemisia annua. ACTs are currently the fastest-acting treatment for relieving malaria symptoms and are more effective than the traditional monotherapies listed above. ACTs may also help reduce transmission rates of malaria by reducing the number of gametocytes - the infective version of the parasite - into the bloodstream. There is also little documented resistance to ACTs, and artisiminin compounds can even retard resistance to the partner drugs used in combination therapies. The downside is that ACTs are more expensive than traditional monotherapies.

Resistance to Anti-Malarial Drugs has become a huge problem in many developing countries as a result of inappropriate use - inexpensive monotherapies were deployed on a large scale and their use was poorly managed despite increasing resistance levels, due to weak health care infrastructure. Increasing resistance makes traditional drugs like chloroquine and SP therapies ineffective and results in increased mortality from malaria. The WHO recommends and provides technical assistance to help with monitoring the efficacy of malaria treatments and with implementing ACT therapies. 

There Is No Magic Bullet in eradicating malaria. A recent study suggested that over 6 million malaria cases in Africa, representing a third of the cases reported in infants in the most vulnerable areas, could be prevented through administering intermittent anti-malarial treatments before the children are even infected. Research found that intermittent preventative treatment (IPTi) helped children build better immunity to malaria and also reduced the risk of the parasite becoming drug-resistant. Both of these benefits decreased if treatment was given continuously. While this study has promising implications, it is not a complete solution and there is the risk that if carried out inappropriately this intervention could potentially increase drug resistance. Eradicating malaria worldwide requires an integrated approach and a strong and sustained focus on research in order to keep developing new treatments to combat the problem of drug resistance.