Malaria is a vector-borne disease that is spread by Anopheles mosquito carrying parasite Plasmodium. The parasite enters the human blood through the saliva of a mosquito, replicates in the liver and infects red blood cells. The symptoms of malaria are shaking chills, high fever, headache, sweating, and flu-like symptoms. Malaria is diagnosed by blood tests, rapid diagnostic tests, and other tests. Malaria should be managed properly through antimalarial and antibiotics to prevent recurrences and remissions.
What is The Best Treatment for Malaria?
Malaria shows recurrences and relapses if not treated properly. The human does not develop immunity against malarial infection. The drug resistance has become biggest hurdle for treatment of malaria in some geographical areas, especially in endemic areas. The disease has been showing constant health problems despite a lot of innovations in medicines.
If a patient is treated for malaria, and the patient leaves taking medicine in the mid of treatment due to any reason, malaria returns back and he develops resistance to the previous medicines he was consuming. It becomes complicated to treat in the second relapse. The physician has to try different antimalarial medicine for the second time to prevent relapse and provide effective treatment.
The choice of medicine depends upon the following factors-
- Your age
- The species of parasite Plasmodium causing the disease
- The area from where you acquired the disease and its drug resistance status
- Your clinical status
- Any illness that you have with malaria
- Your sensitivity to any drug, i.e. drug allergies you might have
- The severity of the case.
After the evaluation of the case, your physician will start with supportive management and appropriate medicine to control symptoms. Fluids and electrolytes are provided as supportive therapy. Anti-seizure medicines may be required in some of the cases.
Safety measures should also be adopted along with medications to avoid remissions and transmission of the disease by preventing mosquito bites. These are regular use of long sleeves, long pants, insect repellants and insecticide-treated bed nets.
Antibiotics are given in combination with antimalarial medicines for the therapeutic management of severe and complicated cases, and cases where there are special risks with uncomplicated malaria although no vaccine is commercially available for prevention of malaria.
The commonly used antimalarial drugs for the treatment of malaria are following-
Chloroquine- Chloroquine is most effective antimalarial medicine against P. ovale, P. vivax, P. malariae and drug sensitive P. falciparum.
Quinine- Quinine is preferred as the second choice of medicine in drug-resistant P. falciparum.
Quinidine Gluconate- It is used in combination with tetracycline, doxycycline, or clindamycin for treatment of severe or complicated malaria.
Tetracycline- Tetracycline has potential antimalarial effect by impairing the progeny of apicoplast genes.
Artemether and lumefantrine (Coartem)- It is given to treat acute, uncomplicated P. falciparum malaria.
Atovaquone- They are used in combination with chloroquine to treat uncomplicated P. falciparum malaria.
Mefloquine- Mefloquine is used for the treatment of drug-resistant malaria.
Primaquine (sold as a generic)- It is used to control hypnozoite stage of P. ovale and P. vivax to prevent relapse.
Clindamycin (Cleocin)- It is prescribed in the combination of quinine or quinidine for treatment of drug-resistant malaria.
Doxycycline- It is paired with quinine or quinidine to treat malaria caused by P. falciparum.
Artesunate- Artemisinin-based combination therapies are the best available antimalarial medicines currently. The ACTs are the combination of two active ingredients with their different mechanisms of action and are highly recommended by WHO. It is best effective therapy against malaria caused by P. falciparum.
You should complete the course of medicine as guided by your physician even if you feel better to prevent the recurrence and drug resistance developed due to incomplete treatment of malaria.
- World Health Organization (WHO) – Malaria: https://www.who.int/health-topics/malaria
- Centers for Disease Control and Prevention (CDC) – Malaria: https://www.cdc.gov/malaria/index.html
- National Institute of Allergy and Infectious Diseases (NIAID) – Malaria: https://www.niaid.nih.gov/diseases-conditions/malaria
- World Malaria Report 2020 – WHO: https://www.who.int/publications/i/item/9789240015791