The use of Artemisinin-based combination therapies (ACTs) to prevent malaria transmission

Topics: Malaria, Plasmodium falciparum, Plasmodium Pages: 8 (2693 words) Published: October 17, 2013
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‘The use of Artemisinin-based combination therapies (ACTs) to prevent malaria transmission’ Problem
Malaria is a life-threatening disease caused by parasites that are transmitted to people through the bites of infected mosquitoes. In 2010, malaria caused an estimated 655,000 deaths (with an uncertainty range of 537,000 to 907,000), mostly among African children. Increased malaria prevention and control measures are dramatically reducing the malaria burden in many places but it is still a massive problem. According to the World malaria report 2011, there were about 216 million cases of malaria (with an uncertainty range of 149 million to 274 million) and an estimated 655,000 deaths in 2010 (with an uncertainty range of 537,000 to 907,000). Malaria mortality rates have fallen by more than 25% globally since 2000 and by 33% in the WHO (World Health Organisation) African Region. Most deaths occur among children living in Africa where a child dies every minute from malaria.1 Malaria is caused by Plasmodium parasites. The parasites are spread to people through the bites of infected Anopheles mosquitoes, called "malaria vectors", which bite mainly between dusk and dawn. There are four parasite species that cause malaria in humans: Plasmodium falciparum

Plasmodium vivax
Plasmodium malariae
Plasmodium ovale.

Approximately half of the world's population is at risk of malaria. Most malaria cases and deaths occur in sub-Saharan Africa. However, Asia, Latin America, and to a lesser extent the Middle East and parts of Europe are also affected. In 2010, 99 countries and territories had on-going malaria transmission. Specific population risk groups include:

Young children in stable transmission areas who have not yet developed protective immunity against the most severe forms of the disease. Non-immune pregnant women as malaria causes high rates of miscarriage and can lead to maternal death. Semi-immune pregnant women in areas of high transmission. Malaria can result in miscarriage and low birth weight, especially during first and second pregnancies. Semi-immune HIV-infected pregnant women in stable transmission areas, during all pregnancies. Women with malaria infection of the placenta also have a higher risk of passing HIV infection to their new-born’s. People with HIV/AIDS.

International travellers from non-endemic areas because they lack immunity. Immigrants from endemic areas and their children living in non-endemic areas and returning to their home countries to visit friends and relatives are similarly at risk because of waning or absent immunity.2

This graph shows the countries mainly affected by malaria, not only are they third world countries but these countries have a perfect climate for diseases and infections to spread.3 Solution Plasmodium falciparum resistance to chloroquine and sulphadoxine–pyrimethamine has led to the recent adoption of artemisinin-based combination therapies (ACTs) as the first line of treatment against malaria. ACTs comprise semisynthetic artemisinin derivatives paired with distinct chemical classes of longer acting drugs. These artemisinins are exceptionally potent against the pathogenic asexual blood stages of Plasmodium parasites and also act on the transmissible sexual stages. Artemisinin-based combination therapies (ACTs) are the best anti-malarial drugs available now. Artemisinin enhances efficacy and has the potential of lowering the rate at which resistance emerges and spreads. Under low transmission intensity, ACTs have an additional public health benefit of reducing the overall malaria transmission and studies are urgently needed to investigate modalities of attaining similar benefits under high transmission. Despite being recommended by WHO since 2001, overall deployment of ACT has been slow. Limiting factors are...

Bibliography: JL, V. (2004). Identification of an antimalarial synthetic trioxolane drug development candidate. Nature, 900-904.
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