190

■Bio-mathematics, Statistics and Nano-Technologies: Mosquito Control Strategies

10.3

Resistance to antimalarial treatment, a global

threat ...........

192

10.4

Clinical pharmacokinetics of antimalarial drugs ............................

194

10.5

Treatment of pregnant women .............................................

197

10.6

Treatment of infants and young children ...................................

199

10.7

Conclusion ................................................................

203

10.1

INTRODUCTION

Malaria is a parasitic disease transmitted mainly by the bite of an infected female

Anopheles mosquitos. Although more than 120 plasmodium species exist, only five of

them cause malaria in humans viz: Plasmodium falciparum, Plasmodium vivax, Plasmod-

ium ovale, Plasmodium malariae and Plasmodium knowlesi. P. falciparum and P. vivax

are the most infectious parasites in Africa and in many countries outside Sub-Saharan

Africa (SSA), respectively. P. falciparum has been reported to be responsible for most of

the deaths, accounting for more than 99% of the entire malaria related mortalities world-

wide. Though P. vivax is largely associated with uncomplicated malaria, evidence exists

of its possibility to trigger severe malaria [1]. Although P. malariae and P. ovale are usu-

ally associated with uncomplicated malaria, they can hardly cause other complications

[1, 2, 3]. P. knowlesi cause malaria in both humans and some primates. Upon the bite of

the mosquito, the parasite goes to the liver for maturation; and after some days, it migrates

to the bloodstream where it infects red blood cells (RBCs). While inside the RBCs, it takes

48−72h for the parasites to multiply, and therefore, causing rupturing of RBCs. Then the

RBCs continue getting infected by the parasite with subsequent symptoms that follow in

48−72h [1].

Almost 50 % of the earth’s population are at risk of getting malaria, which is presently

widespread in tropical and subtropical countries, including all of SSA together with huge

areas of South East Asia, Eastern Mediterranean, Western Pacific, and the Americas [2].

According to the 2019 world malaria report, over 400,000 deaths in 2019 were due to

malaria [3]. Malaria caused 405,000 mortalities worldwide in 2018, and 94 % of all mor-

talities happened in Sub Saharan Africa. Global mortalities caused an overwhelming US

$ 3.1 billion financial burden [1, 2].

Worldwide, a child perishes every two minutes as a result of malaria. Africa bears

about 90% of all malaria mortalities especially among children [4, 5, 6]. Children below 5

years of age suffer the greatest burden of the disease representing more than 50% of world-

wide deaths. In Africa, the risk of severe anemia linked to malaria is greatest in children

under the age of five and is a cause of an elevated risk of perishing from severe malaria

especially when hemoglobin levels drop below 1.86 mmol/L (3g/dL) [2, 7, 8, 9].

In pregnancy, malaria is detrimental to both the pregnant woman and the fetus. Out

of ten maternal mortalities in malaria regions, one is likely to be caused by P. falciparum.