ABOUT

• Mosquito-borne infectious disease
• Caused by various species of the parasitic protozoan microorganisms called Plasmodium
• The first evidence of this protozoan came from mosquitoes preserved in amber nearly 30 million years ago.
• It is even thought to have brought the Roman Empire to its knees. Malaria was so prevalent during the Roman times that the disease is also called ‘Roman Fever’
• Today, the credit for actually discovering the parasite is given to Charles Louis Alphonse Laveran, a French physician. He even won the Nobel Prize in 1907 for his findings.
• Causes of Malaria
  • Bitten by a malarial vector (Anopheles stephensi)
  • Use of shared and infected syringes.
  • Organ transplantation.
  • From an infected mother to her baby during birth.

What is in news : Instances of drug resistant malaria are increasing in India

DRUG RESISTANCE

• In most malaria-endemic countries including India, Artemisinin-based antimalarial drugs are the first-line choice for malaria treatment especially against Plasmodium falciparum parasite which is responsible for almost all malaria-related deaths in the world. In recent years there is increasing evidence for the failure of artemisinin-based combination therapy for falciparum malaria either alone or with partner drugs.
• A recent study described the presence of two mutations responsible for artemisinin resistance in Northern Uganda. The current report of artemisinin resistance in East Africa is a matter of great concern as this is the only drug that has saved several lives across the globe
• In India, after the failure of chloroquine to treat P. falciparum malaria successfully, artemisinin-based combination therapy was initially introduced in 117 districts that reported more than 90% falciparum burden in 2008.
• In 2010, artesunate plus sulfadoxine-pyrimethamine (AS+SP) was introduced universally, but in 2013, in view of resistance to the partner drug SP in the seven North Eastern States, the combination partner was replaced by artemether-lumefantrine (AL) for these states.
• In 2019, a report from Eastern India indicated the presence of two mutations in P. falciparum cases treated with artemisinin that linked to its presence of resistance.
• Again in 2021, artemisinin-based combination therapy failure was reported from Central India where the partner drug SP showed triple mutations with artemisinin wild type.
• This means the failure of artemisinin-based combination therapy may not be solely linked to artemisinin. Here it is needed to change the partner drug as has been done in NE states in 2013.
• In the past, chloroquine was very effective for all types of malaria treatment in India. But it is no longer used for the treatment of falciparum malaria.
• Though there have been some reports of chloroquine resistance in P. vivax malaria, this drug is still the effective choice to treat this species.
• Reports of the presence of chloroquine resistance mutations in some vivax-dominated areas are a cause of concern and continued monitoring is needed.