Biopharmaceutical Solutions

Background information

• What is Malaria?
  Malaria is a parasitic disease transmitted by infected mosquitoes. It can be categorized as either uncomplicated or severe. Symptoms of uncomplicated malaria include fever, chills, body aches, nausea, headache, vomiting, and diarrhea. Severe disease can cause anemia, acute respiratory distress syndrome, coma, and death.
• Global burden
  Half of the world’s population is at risk for malaria. In 2006, there were an estimated 246 million malaria cases and nearly 1 million deaths. Over 90 percent of malaria deaths occur in Africa; 85 percent of deaths were in children under the age of five. In Africa, malaria has been estimated to result in more than $12 billion in lost annual gross domestic profit; malaria control would cost a fraction of this sum.
• Geographic distribution
  Malaria is endemic in more than 100 countries in tropical and subtropical regions of Africa, Asia, and Central and South America.
• Causative agent/transmission
  Malaria is caused by four species of protozoa of the genus Plasmodium: P. falciparum, P. vivax, P. ovale, and P. malariae.  P. falciparum causes the most severe and deadly form of the disease. P. vivax is less deadly, but worldwide, is the most prevalent Plasmodium parasite and is the cause of the most morbidity. Transmission of all species occurs via the bite of an infected female Anopheles mosquito.

Presentation

Once in the bloodstream, parasites migrate to the liver, invade hepatocytes, and undergo multiple rounds of replication. Following this asymptomatic period (which lasts anywhere from a week to months depending on the species of Plasmodium), parasites are released from the hepatocyte and infect red blood cells (RBCs). During this blood or erythrocytic stage, parasites replicate several times inside the RBCs, eventually causing them to burst and thereby freeing the parasites to infect new RBCs. The symptoms of uncomplicated disease are associated with the erythrocytic stage. The destruction of RBCs may also cause jaundice and anemia. Severe disease may result inkidney failure, seizures, or coma.

Trends

Increasingly, Plasmodium are resistant to existing antimalarials. Use of combination therapies and the development of new drugs and vaccines are strategies being pursued to guard against drug resistance.
Several Anopheles vector species are exhibiting pesticide resistance, even to the powerful pesticide DDT.

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