Efforts Made to Eliminate Drug-Resistant Malaria and Its Challenges

Abstract

Since 2000, a good deal of progress has been made in malaria control. However, there is still an unacceptably high burden of the disease and numerous challenges limiting advancement towards its elimination and ultimate eradication. Among the challenges is the antimalarial drug resistance, which has been documented for almost all antimalarial drugs in current use. As a result, the malaria research community is working on the modification of existing treatments as well as the discovery and development of new drugs to counter the resistance challenges. To this effect, many products are in the pipeline and expected to be marketed soon. In addition to drug and vaccine development, mass drug administration (MDA) is under scientific scrutiny as an important strategy for effective utilization of the developed products. This review discusses the challenges related to malaria elimination, ongoing approaches to tackle the impact of drug-resistant malaria, and upcoming antimalarial drugs.

Self-medication and Anti-malarial Drug Resistance in the Democratic Republic of the Congo (DRC): A silent threat

“…For lack of means, some resort to traditional medicine in the event of malaria using an infusion or a decoction based on the bark of Quinquina (Cinchona officinalis). Plasmodium falciparum develops resistance to several drugs globally, so its resistance only targets quinine and Artemisinin derivatives (the most widely used antimalarials in our region) [ 13 ].…”

“…Studies indicated that self-medication is associated with inappropriate treatments and polychemotherapy [ 12 , 13 ]). In Bukavu, a town in the eastern region of the DRC, and elsewhere in the country, there are no regulations on the sale and use of pharmaceuticals, which then results in a high incidence of self-medication of Antimalarial drugs [ 11 ].…”

Chemical and Pharmacological Properties of Decoquinate: A Review of Its Pharmaceutical Potential and Future Perspectives

“…To prevent the development of parasite resistance, therapeutic management with drugs that inhibit the major pathogens is required. In the case of cytochrome bc 1 inhibitors, new antimicrobial agents are being explored primarily with this goal in mind [ 66 , 67 ]. DQ has previously been described as a drug that exhibits cross-resistance.…”

“…It should be clarified that DQ has limited cross-resistance to atovaquone-resistant parasites, with mutations A122T and Y126C at the cytochrome b binding site. However, one mutation that occurs in atovaquone is Y268S, which leads to late treatment failure [ 66 ]. Another mutation that leads to atovaquone resistance and corresponds to one of the most common mutations in P. falciparum is Y279S, which led to the reversal of the DQ snapping position.…”

“…Careful therapy against the development of parasite resistance involves therapeutic management with drugs that inhibit the major pathogens. In the case of cytochrome bc 1 inhibitors, new antimicrobial agents are being explored primarily with this goal in mind [ 66 , 67 ]. DQ, for example, has already been described as a drug that exhibits cross-resistance, i.e., the ability of coccidia to survive the anticoccidial effects of a drug to which they have never been exposed because they have already developed resistance to a chemical agent [ 73 ].…”