A Review: Malaria

Abstract

One of the biggest threats to world health is still malaria, especially in tropical and subtropical areas. Herbal treatments have long been used to cure malaria, particularly in areas with limited access to contemporary medical care. Herbal medications have garnered scientific recognition when Artemisinin was discovered in Artemisia annua. On the other hand, the mainstay of malaria therapy has been allopathic medications like primaquine, chloroquine, and artemisinin-based combination treatments (ACTs). However, interest in plant-based substitutes has increased due to the emergence of drug-resistant strains. The aetiology, pathophysiology, diagnosis, and treatment of malaria are highlighted in this overview, with a comparison of allopathic and herbal methods.In comparison to traditional antimalarial medications, it seeks to investigate the effectiveness, safety, drawbacks, and prospects of herbal formulations. With scientific backing, the use of herbal medicine into contemporary treatment may present novel approaches to the long-term management and control of malaria.

Introduction

Overview:

Malaria is a life-threatening disease caused by Plasmodium parasites, transmitted to humans via the bites of infected female Anopheles mosquitoes. The most dangerous species are Plasmodium falciparum and P. vivax. The disease affects hundreds of millions globally, especially in tropical and subtropical regions.

History:

The term “malaria” comes from the Italian for “bad air,” reflecting early beliefs about its origin. Its true cause was identified in 1897 by Sir Ronald Ross, who discovered mosquitoes as the disease’s vector.

Epidemiology and Global Burden:

• In 2020, there were 241 million cases and approximately 627,000 deaths globally.

• Africa bears over 90% of the global burden, especially among children under five and pregnant women.

• Transmission is influenced by climate, migration, and vector control efforts.

Causative Organisms & Life Cycle:

• Caused by five Plasmodium species.

• Lifecycle includes:

  • Sporozoites entering the liver.

  • Formation of merozoites that infect red blood cells, causing symptoms like fever, chills, and anemia.

  • Gametocytes are taken up by mosquitoes, continuing the cycle.

  • P. vivax and P. ovale can cause relapses due to dormant liver stages (hypnozoites).

Control Initiatives:

Global efforts include:

• Roll Back Malaria (RBM)

• WHO Global Strategy (2016–2030)

• The Global Fund

• President’s Malaria Initiative (PMI)
  Focus areas: diagnosis, ACTs, bed nets, health system strengthening. Challenges include funding gaps, climate change, and emergencies like COVID-19.

Diagnosis:

• Microscopy with Giemsa-stained smears (gold standard)

• Rapid Diagnostic Tests (RDTs)

• PCR for high sensitivity and mixed infections

• Diagnosis is supported by clinical symptoms and travel history.

Treatment:

• Artemisinin-based Combination Therapies (ACTs) are first-line for P. falciparum.

• P. vivax and P. ovale require primaquine for liver-stage clearance.

• Severe malaria is treated with IV artesunate, followed by oral ACTs.

• Drug resistance is a growing concern, especially in Asia and Africa.

Herbal Drugs in Malaria Treatment:

Herbal plants like Artemisia annua (source of artemisinin), Swertia chirata, Neem, and Cinchona bark (source of quinine) have shown antimalarial activity. These traditional remedies may offer affordable, multi-targeted, and better-tolerated alternatives, especially in resource-limited settings.

Allopathic Drugs:

Include:

• ACTs (e.g., artemether-lumefantrine)

• Chloroquine for P. vivax (if no resistance)

• Primaquine, quinine, atovaquone-proguanil, and antibiotics (e.g., doxycycline)
  Allopathic drugs are standardized and fast-acting but face challenges with side effects and growing resistance.

Herbal vs. Allopathic – Comparative Analysis:

• Herbal: Culturally accepted, affordable, multi-targeted, but lacks standardization and clinical validation.

• Allopathic: Fast, standardized, evidence-based, but expensive and resistance-prone.

• Integration of both systems through phytopharmaceuticals may improve efficacy and reduce resistance.

Future Scope:

• Emphasis on combining traditional knowledge and modern science

• Focus on standardizing phytoconstituents, nanotechnology, AI-driven screening, and new delivery systems

• Herbal research holds promise in combating drug-resistant malaria and offering cost-effective alternatives.

Conclusion

In order to effectively cure malaria, both allopathic and natural remedies are crucial. In acute care settings, allopathic medications—especially ACTs—are essential because they provide quick and consistent relief. However, the necessity for alternate or adjunct therapy is highlighted by the rising problem of medication resistance and adverse effects. Rich in bioactive components and supported by centuries of traditional usage, herbal medicines have a lot of promise, especially when scientific study validates them. Future malaria therapies might be more efficient, reasonably priced, and environmentally friendly if both systems are balanced and current science and traditional knowledge are combined.

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Copyright

Copyright © 2025 Mr. Rajesh Chhabeelal Patil, Ms. Ketakee More, Ms. Arti Gadade, Mr. Nitin Gawai, Mr. Vivek Patil. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.