The best way to treat malaria



By Ifeyinwa Ugo-Amadi



Malaria is a mosquito-borne disease caused by a parasitic protozoan known as Plasmodium. It was estimated to infect about 198 million people resulting in the death of about 584 000 people as at 2013. Of this number, about 90% of them are in Africa.1 Of all the disease causing species of the genus Plasmodium, P. falciparum is known to cause more deaths.

Plasmodium is transmitted by the female anopheles mosquito and is introduced into the bloodstream of humans as the mosquito feeds. The infective form of the protozoan gets to the liver from the blood stream and reproduces in it. Then, it infects the red blood cells and destroys it; consuming the haemoglobin.

Malaria is a preventable and treatable disease. However, prevention has been difficult in some regions of the world because most mosquitoes have developed resistance to insecticides and other ways of curbing the proliferation of mosquitoes are not adhered to. Drug resistance has made many erstwhile effective antimalaria agents ineffective in treating malaria. The current use of artemisinin-based combination therapies (ACTs) as first-line drugs in the treatment of malaria aims at slowing drug resistance.

 ACTs are drugs that contain the artemisinin molecule or its derivative as the main molecular ingredient, to it is attached another Plasmodium-killing drug. Artemisinin contains an unusual peroxide bridge believed to be responsible for its mechanism of action. When the artemisinin comes in contact with the protozoa, the iron consumed by the parasite reduces this peroxide bond resulting in the generation of highly reactive radicals. These radicals damage the parasite membrane by covalently binding to its membrane protein.

Symptoms appear between 10-15 days after bite from an infected mosquito. They include; weakness, chills, fever, headache, vomiting etc. These symptoms arise as a result of the
depletion of the red blood cells and action of the immune system to the release of toxic wastes by the parasite.  Depletion of red blood cells can hinder the transportation of oxygen which is necessary for other metabolic activities.

The use of multivitamins containing trace elements such as Fe2+, Cu2+ and Zn alongside ACTs have been advised against because these trace elements reduce the efficacy of the drug . Trace elements have the ability to catalyse the physiological breakdown of the peroxide bridge through an auto induced hydrolytic cleavage. When artemisinin is taken with any of these multivitamins, the trace elements activate the artemisinin before it gets to the target cell(malaria parasite) causing it to destroy other cells rather than the malaria parasite. This makes the ACTs inactive to the malaria parasite. If needed, supplements which will not catalyse the breakdown of the peroxide bridge of artemisinin is preferable as it promotes appetite, quick recovery and does not hinder the efficacy of ACTs.

An iron supplement which does not dissociate to form Fe2+ in the body yet promotes appetite and quick recovery is the Iron (III) polymaltose. Iron (III) polymaltose complex is made of non-ionic iron (III), in form of polynuclear iron (III) hydroxide and polymaltose ligands. The resulting complex is stable. Being in a non-ionic form, iron from iron (III) polymaltose does not interact with food components and ACTs.


References

1http://www.who.int/mediacentre/factsheets/fs094/en/





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