TY - JOUR
T1 - Update on diagnostic and treatment of uncomplicated and complicated malaria in adults and selected vulnerable populations
AU - Botha, Philip
AU - Bottieau, Emmanuel
AU - Uthman, Olalekan
AU - Obike, Ude
AU - Nachega, Jean B.
PY - 2013
Y1 - 2013
N2 - Although malaria remains one of the most important infectious causes of morbidity and mortality world-wide with 40% of the global population at risk, significant progress has been made toward elimination, notably with the development and use of rapid diagnostic tests, insecticide-treated bed nets, indoor residual spraying, and artemisinin-based combination therapies (ACTs). P. falciparum infection remains the most common cause of severe infection and death, but non-P. P. falciparum infections, including the recently emerged 5th plasmodium species, P. knowlesi, are increasingly recognized as causes of severe disease, especially in southeast Asia. Chemotherapy for severe infections has been revolutionized following results of the SEQUAMAT and AQUAMAT trials showing that parenteral artesunate (versus quinine) reduced severe malaria mortality by 34.7% and 22.5% in Asian adults and African children, respectively, making it the drug of choice for severe malaria. However, rising rates of artemisinin resistance, currently confined to the Greater Mekong sub-region, are threatening the long-term efficacy of artemisinins. HIV infection remains an important risk factor for death and severe disease due to malaria. The full amplitude of mutual interactions between these conditions is only beginning to be elucidated while the complex, multi-directional and pharmacokinetic interactions between antimalarial agents and HIV drugs continue to emerge.
AB - Although malaria remains one of the most important infectious causes of morbidity and mortality world-wide with 40% of the global population at risk, significant progress has been made toward elimination, notably with the development and use of rapid diagnostic tests, insecticide-treated bed nets, indoor residual spraying, and artemisinin-based combination therapies (ACTs). P. falciparum infection remains the most common cause of severe infection and death, but non-P. P. falciparum infections, including the recently emerged 5th plasmodium species, P. knowlesi, are increasingly recognized as causes of severe disease, especially in southeast Asia. Chemotherapy for severe infections has been revolutionized following results of the SEQUAMAT and AQUAMAT trials showing that parenteral artesunate (versus quinine) reduced severe malaria mortality by 34.7% and 22.5% in Asian adults and African children, respectively, making it the drug of choice for severe malaria. However, rising rates of artemisinin resistance, currently confined to the Greater Mekong sub-region, are threatening the long-term efficacy of artemisinins. HIV infection remains an important risk factor for death and severe disease due to malaria. The full amplitude of mutual interactions between these conditions is only beginning to be elucidated while the complex, multi-directional and pharmacokinetic interactions between antimalarial agents and HIV drugs continue to emerge.
KW - Artemisinin
KW - Malaria
KW - Quinine
KW - Treatment
UR - http://www.scopus.com/inward/record.url?scp=84893439234&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84893439234&partnerID=8YFLogxK
U2 - 10.2174/1871526513666140103122630
DO - 10.2174/1871526513666140103122630
M3 - Article
C2 - 24387665
AN - SCOPUS:84893439234
SN - 1871-5265
VL - 13
SP - 278
EP - 291
JO - Infectious Disorders - Drug Targets
JF - Infectious Disorders - Drug Targets
IS - 4
ER -