Therapy Analysis - Malaria
Malaria - earliest treatments
Quinine, which functions by disrupting the parasites' reproduction, has saved countless lives, but it is short-acting and overuse results in serious side effects including hearing loss.The first recorded treatment for malaria was the bark of the cinchona tree, which contains quinine. The bark was introduced to Europe as a malarial treatment by Jesuits in the 1640s; however, until cinchona tree plantations were established in India, Sri Lanka and Java in the 1800s the only source of the world's quinine was the cloud forests on the slopes of the Andes, in modern day Peru and Ecuador.
Quinine, which functions by disrupting the parasites' reproduction, has saved countless lives, but it is short-acting and overuse results in serious side effects including hearing loss. Quinine remains in use today in the Western world mainly as a flavouring additive in tonic water, vermouth and some soft drinks.
During the 1940s two major innovations led to malaria being virtually eradicated in some parts of the world. The first breakthrough was the development of a synthetic, safe, inexpensive, long-lasting anti-malarial compound called chloroquinine. The second innovation was the development of the pesticide dichloro-diphenyl-trichloroethane (DDT) which was able to kill off mosquitoes for substantial periods of time (monthly timespans) - long enough to disrupt the insects' life cycle and halt the transmission of disease. A global malaria eradication programme launched by the World Health Organisation (WHO) in 1955 achieved some measure of success and much of the Caribbean and South Pacific became virtually malaria-free. By the 1990s however, malaria had made a dramatic comeback and is now afflicting a greater number of people than ever before. In fact, it is estimated that if the prevalence of malaria continues to increase at its current rate the death rate could double within the next 20 years.
The reasons for malaria's comeback are multifaceted, but perhaps the largest contributing factor is the spread of chloroquinine resistance in the Plasmodium parasite from Asia to Africa. Cutbacks of malaria control programmes, environmental changes such as road building, mining and irrigation creating breeding grounds for mosquitoes and the banning of DDT use due to environmental and human health concerns have also had an enormous impact.
