Malaria is considered one of the most important and devastating infectious diseases in the world, causing an estimated 1 million deaths per year, mainly of children under the age of five in Africa. Although malaria could be a preventable disease, it has become endemic throughout the largest part of the tropics. According to data from the World Health Organization, however, the disease is most readily transmitted in sub-Saharan Africa.
The microorganism P. falciparum has been reported as the main cause of nearly all serious illnesses and deaths from malaria. In addition to its impact on the health and destiny of the people ie in developing countries, malaria has also been indicated as a major constraint to the overall economic development of the affected nations. Severe malaria is difficult to diagnose precisely in the regions where malaria is endemic and is generally defined as acute malaria after major signs of organ dysfunction or high levels of parasitemia have been detected. Young children and pregnant women are particularly in severe danger of malaria infection in those areas.
Although many medicines are available for the treatment of uncomplicated malaria, there could be obstacles preventing its effective control, such as drug resistance, toxic effects, and the high cost and limited availability of or lack of access to some drugs. Quinine/quinidine have been the standard therapies for severe cases of falciparum malaria for a long time. However, their application often leads to toxic effects, including hearing loss, nausea, vomiting, dizziness, hypoglycemia, and visual disturbances, cardiotoxicity. What is more, the efficacy of quinine has decreased in some areas, especially in Southeast Asia due to partial resistance limiting the drug’s efficacy against severe malaria.
The most advanced, powerful, and important new class of antimalarial drugs, is the artemisinins – naturally derived products originally developed in China. They are obtained through isolation from the plant Artemisia annua (sweet wormwood). Artemisinin and its derivatives can decrease quickly the levels of parasites in the blood of patients with malaria. This group of medicines is officially recommended by the World Health Organization as the first-line treatment for uncomplicated P. falciparum malaria. The artemisinin-based agents in combination with other therapies have proven the most effective in malaria treatment.