Malaria - Health Care and Fitness

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Thursday, April 14, 2016



Malaria, caused by 4 species of the protozoal parasite Plasmodium, is endemic in most parts of India and other tropical countries. It is one of the major health problems. As per latest WHO estimates there are 300-500 million new clinical cases globally and > 1 million deaths occur due to malaria each year, 90% of which are in Africa. In India the National Malaria Eradication Programme (NMEP), started in 1958, achieved near complete disappearance of the disease in 1960s (from 75 million cases in 1950s to 0.1 million cases in 1960s). However, due to the development of insecticide resistance among mosquitoes and other factors, it staged a comeback in the mid 1970s (6.47 million cases in 1976), and continues to prevail in endemic/sub-endemic proportions in different areas.

The bark of Cinchona tree, growing in Peru, was introduced in Europe in the early 17th century as a cure for fevers. Later it was realized to be a specific remedy for malaria.
Quinine, isolated from Cinchona bark in 1820, replaced the crude preparation and continued to be the major antimalarial drug till l942. The world's supply of Cinchona bark for producing quinine was met by Java and neighboring countries. This was cut off from the Germans during World War I and from the Allies during World War II. Due to enormous military importance of malaria and its treatment, intense activity was initiated for the development of antimalarial drugs. Mepacrine was produced in Germany in 1926 and extensively field tested by the Allies during World War II. Chloroquine was produced in USA soon after as a less toxic alternative to mepacrine. It had already been synthesized and used by Germans in
1934 as 'Resochin'. Proguanil was introduced in 1945 by the British as a well tolerated clinical curative.

None of the above drugs were found to be capable of preventing relapses in vivax malaria. Pamaquine was the first 8-aminoquinoline to be tested in Germany in the 1920s.
However, no attention was paid to it because of its poor schizontocide action. This class of drugs was retested during World War II as radical curative and Primaquine emerged as the most desirable drug. Pyrimethamine was produced in 1951 under a planned post-war research
programme for antimalarial drugs. The important additions of the recent years are Mcfloquine, Artemisinin and its derivatives/ congeners, pyronaridine and few other synthetic compounds for resistant falciparum malaria.

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