Review Article: Recent Advances in Childhood Antimalaria Chemotherapy

Abstract

As malaria continues to kill many people in our world and spreading into areas that were never known to have it before, it becomes necessary to make occasional reviews of what therapeutic measures are effective in areas of malaria endemicity. There is a global concern as to reducing malaria morbidity and mortality worldwide. Malaria eradication had been viewed as impossible with the mechanisms used against it and the world has settled for just a control. One of the critical areas of this control is effective case management. As it was the case with tuberculosis, leprosy and bacterial infections, there is a paradigm shift from the monotherapy that have been used for nearly three centuries (Quinine) and nearly 60 years after other drugs were discovered (Chloroquine, since early 1940s and subsequently others) with no remarkable drop in the global morbidity and mortality. The World Health Organization (WHO) now advocates combination therapy, which are mainly Artemisinin–based. We in this article made an extensive review of the combination chemotherapeutic possibilities and advocacy for it to achieve increase survival, reduced disease burden through effective parasitaemic clearance with reduced chance of early recrudescence. A necessary overview has been made of the life cycle and clinical presentation of malaria which has not changed significantly over the years. Also, the combination chemotherapy including Artemisinin-based, Sulphadoxine/Pyrimethamine–based and the non-Artemisinin non-Sulphadoxine/Pyrimethamine-based chemotherapy have all been reviewed and concluded that their use will lead to effective case management and reduced mortality. We therefore advocate for a therapeutic paradigm shift to these combination therapy.

Key words: Combination chemotherapy, antimalaria, childhood, review

Afr. J. Clin. Exper. Microbiol. 2005; 6(2): 129-137