Klin Farmakol Farm. 2005;19(2):89-94

Malaria and its treatment

Zdeněk Fendrich

Katedra farmakologie a toxikologie, Farmaceutická fakulta v Hradci Králové, Univerzita Karlova v Praze

Malaria is the most frequent imported protozoan tropical disease. Nowadays even general practitioners can more frequently come into contact with the disease when treating our tourists returning or migrants coming from endemic areas. Transmission and propagation of malaria requires a Plasmodium protozoan and a disease vector, the female Anopheles mosquito. The following four parasites are pathogenic for man: P. vivax, P. ovale, P. falciparum and P. malariae. Cyclic development of the parasite is therefore limited to two hosts, the mosquito and man. Sexual development of the parasite is located in the intestinal tract of the mosquito and asexual development, during which clinical symptoms of the acute attacks appear, occurs in human erythrocytes. The treatment of intraerythrocytic forms of the parasite, the only ones which produce clinical symptoms, is essential. According to the type of parasite several forms of malaria can be distinguished. P. vivax and P. ovale cause so called “benign“ tertian malaria recurring at approximately 48-hour intervals, i. e. each third day. P. falciparum produces malignant tertian malaria with the highest mortality rate which is responsible for several millions of victims every year and, finally, tropical quartan malaria recurring at approximately 72-hour intervals, i. e. each fourth day, which is produced by P. malariae. For treatment of the acute attacks of malaria the following drugs can be used: chloroquine and its derivatives, quinine and similar drugs such as mefloquine, certain antibiotics such as doxycycline, clindamycin and some other antimalarial drugs such as halofantrin, artesunate and atovaquon. Hepatic forms of parasite, so called hypnozoites, can be treated specifically by primaquine which is of importance in P. vivax and P. ovale but not in P. falciparum and P. malariae because they never form hypnocytes. On the other hand eradication of gametocytes by primaquine or pyrimethamine is important in P. falciparum malaria in endemic areas in order to prevent further dissemination of this dangerous disease.

Keywords: Key words: Malaria, schizontocidal (suppressive) drugs, antimalarial drugs against hypnozoites, drugs against gametocytes.

Published: January 1, 2006  Show citation