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Antimalarial Drugs and the Control and Elimination of Malaria

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Treatment and Prevention of Malaria

Part of the book series: Milestones in Drug Therapy ((MDT))

Abstract

Malaria remains a massive global public health problem despite being readily preventable and treatable. The past decade has seen unprecedented levels of political, technical and financial support that have facilitated the scaling-up of malaria control interventions, particularly the implementation of artemisinin-based combination therapy (ACT) policies. During this window of opportunity for reducing the burden of malaria globally and possibly eventually eliminating malaria, attention now needs to be focussed on ensuring that countries select and implement treatment policies that are not only highly effective, but will also have a prolonged useful therapeutic life, reduce malaria transmission safely and effectively and, where applicable, be active against P. vivax. To reduce the probability of resistance, antimalarials should be used in quality-assured fixed-dose combinations and treatment doses need to be optimised on the basis of pharmacokinetic assessments conducted within therapeutic efficacy studies in each key target population. As important is ensuring optimal targeting and adherence with these treatment policies.

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Notes

  1. 1.

    Malaria eradication is the permanent reduction to zero of the worldwide incidence of malaria infection caused by a specific agent; i.e. applies to a particular malaria parasite species.

  2. 2.

    Malaria control is reducing the disease burden to a level at which it is no longer a public health problem.

  3. 3.

    Malaria elimination is interrupting local mosquito-borne malaria transmission in a defined geographical area, i.e. zero incidence of locally contracted cases.

References

  1. Hay C, Guerra A, Tatem A, Noor R, Snow R (2005) The global distribution and population at risk of malaria: past, present, and future. Lancet Infect Dis 4:327–336

    Article  Google Scholar 

  2. Hay SI, Guerra CA, Gething PW, Patil AP, Tatem AJ, Noor AM, Kabaria CW, Manh BH, Elyazar IR, Brooker S, et al (2009) A world malaria map: Plasmodium falciparum endemicity in 2007. PLoS Med 6:e1000048. Erratum in: PLoS Med 6

    Google Scholar 

  3. Malaney P, Spielman A, Sachs J (2004) The malaria gap. Am J Trop Med Hyg 71:141–146

    PubMed  Google Scholar 

  4. Ward SA, Sevene EJ, Hastings IM, Nosten F, McGready R (2007) Antimalarial drugs and pregnancy: safety, pharmacokinetics, and pharmacovigilance. Lancet Infect Dis 7:136–144

    Article  PubMed  CAS  Google Scholar 

  5. Sachs J, Malaney P (2002) The economic and social burden of malaria. Nature 415:680–685

    Article  PubMed  CAS  Google Scholar 

  6. World Health Organization (2010). Guidelines for the treatment of malaria. Second Edition. http://www.who.int/malaria/publications/atoz/9789241547925/en/index.html. Accessed 1 July 2010

  7. Barnes KI, Watkins WM, White NJ (2008) Antimalarial dosing regimens and drug resistance. Trends Parasitol 24:127–134

    Article  PubMed  CAS  Google Scholar 

  8. Malenga G, Palmer A, Staedke S, Kazadi W, Mutabingwa T, Ansah E, Barnes KI, Whitty CJ (2005) Antimalarial treatment with artemisinin combination therapy in Africa. BMJ 331:706–707

    Article  PubMed  Google Scholar 

  9. Kantele A, Jokiranta TS (2011) Review of cases with the emerging fifth human malaria parasite, Plasmodium knowlesi. Clin Infect Dis 52:1356–1362

    Article  PubMed  Google Scholar 

  10. Drakeley C, Sutherland C, Bousema JT, Sauerwein RW, Targett GA (2006) The epidemiology of Plasmodium falciparum gametocytes: weapons of mass dispersion. Trends Parasitol 22:424–430

    Article  PubMed  Google Scholar 

  11. Barnes KI, White NJ (2005) Population biology and antimalarial resistance: the transmission of antimalarial drug resistance in Plasmodium falciparum. Acta Trop 94:230–240

    Article  PubMed  CAS  Google Scholar 

  12. Barnes KI, Little F, Mabuza A, Mngomezulu N, Govere J, Durrheim D, Roper C, Watkins B, White NJ (2008) Increased gametocytemia after treatment: an early parasitological indicator of emerging sulfadoxine-pyrimethamine resistance in falciparum malaria. J Infect Dis 197:1605–1613

    Article  PubMed  Google Scholar 

  13. White NJ (2008) The role of anti-malarial drugs in eliminating malaria. Malar J 7:S8

    Article  PubMed  Google Scholar 

  14. Babiker HA, Schneider P, Reece SE (2009) Gametocytes: insights gained during a decade of molecular monitoring. Trends Parasitol 24:525–530

    Article  Google Scholar 

  15. Butcher GA (1997) Antimalarial drugs and the mosquito transmission of Plasmodium. Int J Parasitol 27:975–987

    Article  PubMed  CAS  Google Scholar 

  16. Pukrittayakamee S, Chotivanich K, Chantra A, Clemens R, Looareesuwan S, White NJ (2004) Activities of artesunate and primaquine against asexual- and sexual-stage parasites in falciparum malaria. Antimicrob Agents Chemother 48:1329–1334

    Article  PubMed  CAS  Google Scholar 

  17. Bousema T, Okell L, Shekalaghe S, Griffin JT, Omar S, Sawa P, Sutherland C, Sauerwein R, Ghani AC, Drakeley C (2010) Revisiting the circulation time of Plasmodium falciparum gametocytes: molecular detection methods to estimate the duration of gametocyte carriage and the effect of gametocytocidal drugs. Malar J 9:136

    Article  PubMed  Google Scholar 

  18. Nosten F, van Vugt M, Price R, Luxemburger C, Thway KL, Broackman A, McGready R, terKuile F, Looareesuwan S, White NJ (2000) Effects of artesunate-mefloquine combination on incidence of Plasmodium falciparum malaria and mefloquine resistance in western Thailand. Lancet 356:297–302

    Article  PubMed  CAS  Google Scholar 

  19. Barnes KI, Durrheim DN, Little F, Jackson A, Mehta U, Allen E, Dlamini SS, Tsoka J, Bredenkamp B, Mthembu DJ et al (2005) Effect of artemether-lumefantrine policy and improved vector control on malaria burden in KwaZulu-Natal, South Africa. PLoS Med 2:e330

    Article  PubMed  Google Scholar 

  20. Bhattarai A, Ali AS, Kachur SP, MÃ¥rtensson A, Abbas AK, Khatib R, Al-Mafazy AW, Ramsan M, Rotllant G, Gerstenmaier JF et al (2007) Impact of artemisinin-based combination therapy and insecticide-treated nets on malaria burden in Zanzibar. PLoS Med 4:e309

    Article  PubMed  Google Scholar 

  21. Otten M, Aregawi M, Were W, Karema C, Medin A, Bekele W, Jima D, Gausi K, Komatsu R, Korenromp E et al (2009) Initial evidence of reduction of malaria cases and deaths in Rwanda and Ethiopia due to rapid scale-up of malaria prevention and treatment. Malar J 8:14

    Article  PubMed  Google Scholar 

  22. Barnes KI, Chanda P, Ab Barnabas G (2009) Impact of the large-scale deployment of artemether/lumefantrine on the malaria disease burden in Africa: case studies of South Africa, Zambia and Ethiopia. Malar J 8:S8

    Article  PubMed  Google Scholar 

  23. World Health Organization (2010). World Malaria Report. http://www.who.int/malaria/world_malaria_report_2010/en/index.html. Accessed 12 May 2011

  24. Targett G, Drakeley C, Jawara M, von Seidlein L, Coleman R, Deen J, Pinder M, Doherty T, Sutherland C, Walraven G et al (2001) Artesunate reduces but does not prevent post treatment transmission of Plasmodium falciparum to Anopheles gambiae. J Infect Dis 183:1254–1259

    Article  PubMed  CAS  Google Scholar 

  25. Bousema JT, Schneider P, Gouagna LC, Drakeley CJ, Tostmann A, Houben R, Githure JI, Ord R, Sutherland CJ, Omar SA et al (2006) Moderate effect of artemisinin-based combination therapy on transmission of Plasmodium falciparum. J Infect Dis 193:1151–1159

    Article  PubMed  CAS  Google Scholar 

  26. Okell LC, Drakeley CJ, Ghani AC, Bousema T, Sutherland CJ (2008) Reduction of transmission from malaria patients by artemisinin combination therapies: a pooled analysis of six randomized trials. Malar J 7:125

    Article  PubMed  Google Scholar 

  27. Shekalaghe S, Drakeley C, Gosling R, Ndaro A, van Meegeren M, Enevold A, Alifrangis M, Mosha F, Sauerwein R, Bousema T (2007) Primaquine clears submicroscopic Plasmodium falciparum gametocytes that persist after treatment with sulphadoxine-pyrimethamine and artesunate. PLoS One 2:e1023

    Article  PubMed  Google Scholar 

  28. Beutler E, Duparc S; G6PD Deficiency Working Group (2007) Glucose-6-phosphate dehydrogenase deficiency and antimalarial drug development. Am J Trop Med Hyg 77:779–789

    Google Scholar 

  29. Leslie T, Briceño M, Mayan I, Mohammed N, Klinkenberg E, Sibley CH, Whitty CJ, Rowland M (2010) The impact of phenotypic and genotypic G6PD deficiency on risk of Plasmodium vivax infection: A case-control study amongst Afghan refugees in pakistan. PLoS Med 7:e1000283

    Article  PubMed  Google Scholar 

  30. Coleman MD, Coleman NA (1996) Drug-induced methaemoglobinaemia: treatment issues. Drug Saf 14:394–405

    Article  PubMed  CAS  Google Scholar 

  31. Sin DD, Shafran SD (1996) Dapsone- and primaquine-induced methemoglobinemia in HIV-infected individuals. J Acquir Immune Defic Syndr Hum Retrovirol 12:477–481

    Article  PubMed  CAS  Google Scholar 

  32. Shekalaghe SA, terBraak R, Daou M, Kavishe R, van den Bijllaardt W, van den Bosch S, Koenderink JB, Luty AJ, Whitty CJ, Drakeley C et al (2010) In Tanzania, hemolysis after a single dose of primaquine coadministered with an artemisinin is not restricted to glucose-6-phosphate dehydrogenase-deficient (G6PD A-) individuals. Antimicrob Agents Chemother 54:1762–1768

    Article  PubMed  CAS  Google Scholar 

  33. Baird JK (2007) Neglect of Plasmodium vivax malaria. Trends Parasitol 23:533–539

    Article  PubMed  Google Scholar 

  34. Attaran A, Barnes KI, Curtis C, d’Alessandro U, Fanello CI, Galinski MR, Kokwaro G, Looareesuwan S, Makanga M, Mutabingwa T et al (2004) WHO, the Global Fund, and medical malpractice in malaria treatment. Lancet 363:237–240

    Article  PubMed  Google Scholar 

  35. Trape JF (2001) The public health impact of chloroquine resistance in Africa. Am J Trop Med Hyg 64:12–17

    PubMed  CAS  Google Scholar 

  36. Trape JF, Pison G, Spiegel A, Enel C, Rogier C (2002) Combating malaria in Africa. Trends Parasitol 18:224–230

    Article  PubMed  Google Scholar 

  37. Zucker JR, Ruebush TK II, Obonyo C, Otieno J, Campbell CC (2003) The mortality consequences of the continued use of chloroquine in Africa: experience in Siaya, Western Kenya. Am J Trop Med Hyg 68:386–389

    PubMed  CAS  Google Scholar 

  38. Price R, Nosten F, Simpson JA, Luxemburger C, Phaipun L, ter Kuile F, van Vugt M, Chongsuphajaisiddhi T, White NJ (1999) Risk factors for gametocyte carriage in uncomplicated falciparum malaria. Am J Trop Med Hyg 60:1019–1023

    PubMed  CAS  Google Scholar 

  39. Price RN, Simpson JA, Nosten F, Luxemburger C, Hkirjaroen L, ter Kuile F, Chongsuphajaisiddhi T, White NJ (2001) Factors contributing to anaemia in uncomplicated falciparum malaria. Am J Trop Med Hyg 65:614–622

    PubMed  CAS  Google Scholar 

  40. Dondorp AM, Nosten F, Yi P, Das D, Phyo AP, Tarning J, Lwin KM, Ariey F, Hanpithakpong W, Lee SJ et al (2009) Artemisinin resistance in Plasmodium falciparum malaria. N Engl J Med 361:455–67. Erratum in. N Engl J Med 361:1714

    Article  CAS  Google Scholar 

  41. Noedl H, Se Y, Schaecher K, Smith BL, Socheat D, Fukuda MM; Artemisinin Resistance in Cambodia 1 (ARC1) Study Consortium (2008) Evidence of artemisinin-resistant malaria in western Cambodia. N Engl J Med 359:2619–2620

    Article  Google Scholar 

  42. WHO (2010) Global Report on Antimalarial Drug Efficacy and DrugResistance: 2000–2010. WHO, Geneva. http://whqlibdoc.who.int/publications/2010/9789241500470_eng.pd. Accessed 12 May 2011

  43. Bethell D, Se Y, Lon C, Tyner S, Saunders D, Sriwichai S, Darapiseth S, Teja-Isavadharm P, Khemawoot P, Schaecher K et al (2011) Artesunate dose escalation for the treatment of uncomplicated malaria in a region of reported artemisinin resistance: a randomized clinical trial. PLoS One 6:e19283

    Article  PubMed  CAS  Google Scholar 

  44. Anderson TJ, Nair S, Nkhoma S, Williams JT, Imwong M, Yi P, Socheat D, Das D, Chotivanich K, Day NP, White NJ, Dondorp AM (2010) High heritability of malaria parasite clearance rate indicates a genetic basis for artemisinin resistance in Cambodia. J Infect Dis 201:1326–1330

    Article  PubMed  CAS  Google Scholar 

  45. Wongsrichanalai C, Varma JK, Juliano JJ, Kimerling ME, MacArthur JR (2010) Extensive drug resistance in malaria and tuberculosis. Emerg Infect Dis 16:1063–1067

    Article  PubMed  Google Scholar 

  46. White NJ (2004) Antimalarial drug resistance. J Clin Invest 113:1084–1092

    PubMed  CAS  Google Scholar 

  47. Brockman A, Price RN, van Vugt M, Heppner DG, Walsh D, Sookto P, Wimonwattrawatee T, Looareesuwan S, White NJ, Nosten F (2000) Plasmodium falciparum antimalarial drug susceptibility on the north-western border of Thailand during five years of extensive use of artesunate-mefloquine. Trans R Soc Trop Med Hyg 94:537–544

    Article  PubMed  CAS  Google Scholar 

  48. Raman J, Little F, Roper C, Kleinschmidt I, Cassam Y, Maharaj R, Barnes KI (2010) Five years of large-scale dhfr and dhps mutation surveillance following the phased implementation of artesunate plus sulfadoxine-pyrimethamine in Maputo Province, Southern Mozambique. Am J Trop Med Hyg 82:788–794

    Article  PubMed  Google Scholar 

  49. Lubell Y, Reyburn H, Mbakilwa H, Mwangi R, Chonya S, Whitty CJ, Mills A (2008) The impact of response to the results of diagnostic tests for malaria: cost-benefit analysis. BMJ 336:202–205

    Article  PubMed  Google Scholar 

  50. Nosten F, Ashley E, McGready R, Price R (2006) We still need artesunate monotherapy. BMJ 333:45

    Article  PubMed  Google Scholar 

  51. White NJ, Pongtavornpinyo W, Maude RJ, Saralamba S, Aguas R, Stepniewska K, Lee SJ, Dondorp AM, White LJ, Day NP (2009) Hyperparasitaemia and low dosing are an important source of anti-malarial drug resistance. Malar J 8:253

    Article  PubMed  Google Scholar 

  52. Luxemburger C, Nosten F, Raimond SD, Chongsuphajaisiddhi T, White NJ (1995) Oral artesunate in the treatment of uncomplicated hyperparasitemic falciparum malaria. Am J Trop Med Hyg 53:522–525

    PubMed  CAS  Google Scholar 

  53. Simpson JA, Watkins ER, Price RN, Aarons L, Kyle DE, White NJ (2000) Mefloquine pharmacokinetic-pharmacodynamic models: implications for dosing and resistance. Antimicrob Agents Chemother 44:3414–3424

    Article  PubMed  CAS  Google Scholar 

  54. Barnes KI, Little F, Smith PJ, Evans A, Watkins WM, White NJ (2006) Sulfadoxine-pyrimethamine pharmacokinetics in malaria: paediatric dosing implications. Clin Pharmacol Ther 80:582–596

    Article  PubMed  CAS  Google Scholar 

  55. Ringwald P, Keundjian A, Same Ekobo A, Basco LK (2000) Chemoresistance of P. falciparum in urban areas of Yaounde, Cameroon. Part 1: surveillance of in vitro and in vivo resistance of Plasmodium falciparum to chloroquine from 1994 to 1999 in Yaounde, Cameroon. Trop Med Int Health 5:612–619

    Article  PubMed  CAS  Google Scholar 

  56. Checchi F, Piola P, Fogg C, Bajunirwe F, Biraro S, Grandesso F, Ruzagira E, Babigumira J, Kigozi I, Kiguli J et al (2006) Supervised versus unsupervised antimalarial treatment with six-dose artemether-lumefantrine: pharmacokinetic and dosage-related findings from a clinical trial in Uganda. Malar J 5:59

    Article  PubMed  Google Scholar 

  57. Price RN, Hasugian AR, Ratcliff A, Siswantoro H, Purba HL, Kenangalem E, Lindegardh N, Penttinen P, Laihad F, Ebsworth EP et al (2007) Clinical and pharmacological determinants of the therapeutic response to dihydroartemisinin-piperaquine for drug resistant malaria. Antimicrob Agents Chemother 51:4090–4097

    Article  PubMed  CAS  Google Scholar 

  58. Feachem RGA, The Malaria Elimination Group (2009) Shrinking the malaria map: a guide on malaria elimination for policy makers. The Global Health Group, Global Health Sciences, University of California, San Francisco. http://www.malariaeliminationgroup.org/publications. Accessed 1 July 2010

  59. Guerra CA, Howes RE, Patil AP, Gething PW, Van Boeckel TP, Temperley WH, Kabaria CW, Tatem AJ, Manh BH, Elyazar IR et al (2010) The international limits and population at risk of Plasmodium vivax transmission in 2009. PLoS Negl Trop Dis 4:e774

    Article  PubMed  Google Scholar 

  60. Krotoski WA (1985) Discovery of the hypnozoite and a new theory of malarial relapse. Trans R Soc Trop Med Hyg 79:1–11

    Article  PubMed  CAS  Google Scholar 

  61. Price RN, Tjitra E, Guerra CA, Yeung S, White NJ, Anstey NM (2007) Vivax malaria: neglected and not benign. Am J Trop Med Hyg 77:79–87

    PubMed  Google Scholar 

  62. Ratcliff A, Siswantoro H, Kenangalem E, Maristela R, Wuwung RM, Laihad F, Ebsworth EP, Anstey NM, Tjitra E, Price RN (2007) Two fixed-dose artemisinin combinations for drug-resistant falciparum and vivax malaria in Papua, Indonesia: an open-label randomized comparison. Lancet 369:757–765

    Article  PubMed  CAS  Google Scholar 

  63. Pukrittayakamee S, Chantra A, Simpson JA, Vanijanonta S, Clemens R, Looareesuwan S, White NJ (2000) Therapeutic responses to different antimalarial drugs in vivax malaria. Antimicrob Agents Chemother 44:1680–1685

    Article  PubMed  CAS  Google Scholar 

  64. Arias AE, Corredor A (1989) Low response of Colombian strains of Plasmodium vivax to classical antimalarial therapy. Trop Med Parasitol 40:21–23

    PubMed  CAS  Google Scholar 

  65. Galappaththy GNL, Omari AAA, Tharyan P (2007) Primaquine for preventing relapses in people with Plasmodium vivax malaria. Cochrane Database Syst Rev 2007, Issue 1:CD004389. doi: 10.1002/14651858.CD004389.pub2

  66. Baird JK, Hoffman SL (2004) Primaquine therapy for malaria. Clin Infect Dis 39:1336–1345

    Article  PubMed  CAS  Google Scholar 

  67. Mendis K, Rietveld A, Warsame M, Bosman A, Greenwood B, Wernsdorfer WH (2009) From malaria control to eradication: the WHO perspective. Trop Med Int Health 14:802–809

    Article  PubMed  Google Scholar 

  68. Roll Back Malaria (2008) The Global Malaria Action Plan for a malaria free world. http://www.rollbackmalaria.org/gmap/toc.pdf. Accessed 4 July 2010

  69. The malERA Consultative Group on Drugs (2011) A research agenda for malaria eradication: drugs. PLoS Med 8:e1000402

    Google Scholar 

  70. Arrow KJ, Panosian C, and Gelband H (Eds), Institute of Medicine of the National Academies Committee on the Economics of Antimalarial Drugs. Saving lives, buying time: economics of malaria drugs in an age of resistance. The National Academies Press, Washington. http://www.nap.edu/openbook.php?isbn=0309092183. Accessed 17 May 2011

  71. World Health Organization (2009) World Malaria Report. http://www.who.int/malaria/world_malaria_report_2009/en/index.html. Accessed 17 Apr 2011

  72. Ceesay SJ, Casals-Pascual C, Erskine J, Anya SE, Duah NO, Fulford AJ, Sesay SS, Abubakar I, Dunyo S, Sey O et al (2008) Changes in malaria indices between 1999 and 2007 in The Gambia: a retrospective analysis. Lancet 372:1545–1554

    Article  PubMed  Google Scholar 

  73. Kleinschmidt I, Schwabe C, Benavente L, Torrez M, Ridl FC, Segura JL, Ehmer P, Nchama GN (2009) Marked increase in child survival after four years of intensive malaria control. Am J Trop Med Hyg 80:882–888

    PubMed  Google Scholar 

  74. O’Meara WP, Bejon P, Mwangi TW, Okiro EA, Peshu N, Snow RW, Newton CR, Marsh K (2008) Effect of a fall in malaria transmission on morbidity and mortality in Kilifi, Kenya. Lancet 372:1555–1562

    Article  PubMed  Google Scholar 

  75. Sharp BL, Kleinschmidt I, Streat E, Maharaj R, Barnes KI, Durrheim DN, Ridl FC, Morris N, Seocharan I, Kunene S et al (2007) Seven years of regional malaria control collaboration–Mozambique, South Africa, and Swaziland. Am J Trop Med Hyg 76:42–47

    PubMed  Google Scholar 

  76. United Nations Development Programme. Millennium Development Goals. http://www.undp.org/mdg/basics.shtml. Accessed 11 July 2010

  77. Kleinschmidt I, Schwabe C, Shiva M, Segura JL, Sima V, Mabunda SJ, Coleman M (2009) Combining indoor residual spraying and insecticide-treated net interventions. Am J Trop Med Hyg 81:519–524

    PubMed  Google Scholar 

  78. von Seidlein L, Greenwood BM (2003) Mass administration of antimalarial drugs. Trends Parasitol 19:790–796

    Google Scholar 

  79. Kaneko A, Taleo G, Kalkoa M, Yamar S, Kobayakawa T, Björkman A (2000) Malaria eradication on islands. Lancet 356:1560–1564

    Article  PubMed  CAS  Google Scholar 

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Barnes, K.I. (2011). Antimalarial Drugs and the Control and Elimination of Malaria. In: Staines, H., Krishna, S. (eds) Treatment and Prevention of Malaria. Milestones in Drug Therapy. Springer, Basel. https://doi.org/10.1007/978-3-0346-0480-2_1

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