Today is World Malaria Day, and so we wanted to touch on the history & recent developments of the disease, as well as discuss a recent publication in F1000Research which focuses on the treatment of Plasmodium falciparum malaria with chloroquine. Malaria is a mosquito-borne infectious disease which occurs most commonly in tropical and subtropical areas of the world. These areas are hit the most because of the following factors; both species of mosquito which carry the disease exist there, the weather conditions allow transmission to occur all year round, and the low socio-economic stability of these countries can limit efforts to reduce transmission.
Children and pregnant women are generally the most vulnerable groups to malaria, and this is because children have yet to develop any immunity to the disease and the immune systems of pregnant women are generally decreased. In a report from the Centres for Disease Control and Prevention, it was estimated that globally 445,000 people died as a result of malaria, and the majority of these cases were young children located in sub-Subaran Africa. Recently, Asian leaders have made a major push to focus on the fight against malaria. Countries including China, Malaysia and India within the organisation APLMA (Asia Pacific Leaders Malaria Alliance Secretariat, an affiliation of Asia and Pacific heads of government) are working together towards the mutual goal of eliminating malaria in the region by 2030. There is also a malaria vaccine on the horizon, called PfSPZ, which claims to provide 100% protection against the disease. It has proven to be effective in laboratory studies where volunteers gained complete protection. It’s now currently awaiting its first large clinical trial, which will allow the effectiveness of the vaccine to be tested in a real-world application. Researchers are working globally to tackle this life-threatening disease, and with good reason.
As it stands, malaria is the leading cause of death in many developing countries. The impact of the disease also has huge financial ramifications, where the US alone has seen direct costs amounting to $12 billion per year. All efforts towards the treatment could hopefully eradicate the disease. A recent study published in F1000Research investigates the chloroquine resistance among Plasmodium falciparum clinical isolates from Sudan. Chloroquine (chloroquine phosphate) is an antimalarial medication, which can be used both as a preventative and a treatment for malaria. Chloroquine was the first drug of choice for malaria treatment and this was a result of its high efficacy. It was used as the main treatment in Africa for over 50 years. It is also considered one of the safest and cheapest drugs, hence it’s popular use in LMICs. Despite it being a well-established drug, its use has started to decline in Sudan. It’s speculated that this is a result of resistance to the drug in cases of malaria caused by P. falciparum. In this study, the researchers attempted to verify the genetic cause of resistance to chloroquine in P. falciparum isolates.
This emerging drug resistance poses one of the greatest public health challenges to Africa. The study took twenty confirmed P.falciparum cases from the East Nile hospital in Khartoum. The researchers then used nested PCR to isolate the mutation region in the PfCRT gene and amplicons were sequenced via the Sanger sequencing machine. The results of the study found that 80% of the field isolates possessed a codon mutation which allowed chloroquine resistance. This finding suggests a reason for the reduced use of chloroquine as a treatment for P. falciparum malaria. Resistance to malaria medication is a growing concern and therefore efforts and projects like the APLMA and the malaria vaccine are of increasing importance, to limit the spread and devastation caused by this widespread disease.
