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Malaria treatments and prevention
Category: Medicines
Type
Involuntary
Introduction and description
Malaria is a mosquito-borne disease of both humans and other animals. It is caused by eukaryotic protists of the genus Plasmodium.
There were an estimated 225 million cases of malaria worldwide in 2009 and an estimated 655,000 deaths from malaria in 2010. According to the World Health Organization’s 2011 World Malaria Report, malaria accounts for 2.23% of all deaths worldwide. However, a 2012 meta-study from the University of Washington and University of Queensland, published in the Lancet, estimated that 1,238,000 people died from malaria in 2010.
For more details see the section on malaria.
Development of a mature Plasmodium falciparum gametocyte occurs over 10–12 days
Background
There are a number of drugs that are used to prevent malaria while travelling in areas where it exists. Most of these drugs are also sometimes used in treatment.
Because most Plasmodium are these days resistant to medications, one of three medications—mefloquine (Lariam), doxycycline, or the combination of atovaquone and proguanil hydrochloride (Malarone)—is frequently needed. Doxycycline and the atovaquone and proguanil combination are “the best tolerated”; mefloquine is associated with death, suicide, and neurological and psychiatric symptoms.
The use of preventative drugs is impractical for those who reside in areas where malaria exists, and their use is usually only in short-term visitors and travellers. This is due to the cost of the drugs, side effects from long-term use, and the difficulty in obtaining anti-malarial drugs outside of wealthy nations. The use of preventative drugs where malaria-bearing mosquitoes are present has even resulted in the development of partial resistance making treatment more difficult. It has not helped the local population either.
The signs and symptoms of malaria typically begin 8–25 days following infection; however, symptoms may occur later in those who have taken antimalarial medications as prevention, but where the prevention is ineffective.
Side effects
If we now take a look at the side effects of the pharmaceuticals, we find the following.
Using the eHealthme web site to obtain the actual side effects experienced by people, as recorded on Adverse Drug Reports and submitted by doctors to the FDA and SEDA in the USA, just some of the effects of Primaquine for example include:
Nausea | Headache |
Liver Function Tests Nos Abnormal | Pyrexia |
Myalgia | Dehydration |
Jaundice Nos | Weight Decreased |
Thrombocytopenia | Insomnia |
Urine Discolouration | Depression |
Pneumocystis Carinii Pneumonia | Tremor |
Rhabdomyolysis | Drug Toxicity |
Palpitations | Aggression |
Methaemoglobinaemia | Hypertension |
Mefloquine seems to be a major contributor to depression and suicidal thoughts, for example these are examples of just some of the side effects:
Female | Male |
Anxiety | Anxiety |
Insomnia | Depression |
Dizziness | Insomnia |
Paranoia | Headache |
Depression | Confusional State |
Fatigue | Suicidal Ideation |
Nausea | Tinnitus |
Nightmare | Paranoia |
Headache | Hallucination |
Dyspnoea | Fatigue |
Death
Again, using the eHealthme web site to obtain the actual side effects experienced by people, as recorded on Adverse Drug Reports and submitted by doctors to the FDA and SEDA in the USA, the figures for death [USA only] are as follows:
- Aralen - On Apr, 28, 2016: 96 people reported to have side effects when taking Aralen. Among them, 1 people (1.04%) has Death
- Chloroquine phosphate - On Apr, 11, 2016: 777 people reported to have side effects when taking Chloroquine phosphate. Among them, 14 people (1.80%) have Death
- Daraprim - On Apr, 28, 2016: 291 people reported to have side effects when taking Daraprim. Among them, 9 people (3.09%) have Death
- Hydroxychloroquine sulfate - On Apr, 22, 2016: 7,674 people reported to have side effects when taking Hydroxychloroquine sulfate. Among them, 83 people (1.08%) have Death
- Lariam - On Apr, 28, 2016: 2,906 people reported to have side effects when taking Lariam. Among them, 17 people (0.58%) have Death
- Malarone - On Apr, 28, 2016: 1,983 people reported to have side effects when taking Malarone. Among them, 7 people (0.35%) have Death
- Mefloquine - On Apr, 28, 2016: 471 people reported to have side effects when taking Mefloquine. Among them, 1 people (0.21%) has Death
- Mepron - On Apr, 28, 2016: 788 people reported to have side effects when taking Mepron. Among them, 27 people (3.43%) have Death
- Plaquenil - On Apr, 28, 2016: 14,798 people reported to have side effects when taking Plaquenil. Among them, 151 people (1.02%) have Death
- Primaquine - On Mar, 29, 2016: 168 people reported to have side effects when taking Primaquine. Among them, 1 people (0.60%) has Death
- Qualaquin - On Apr, 27, 2016: 149 people reported to have side effects when taking Qualaquin. Among them, 4 people (2.68%) have Death
How it works
The mechanisms by which each drug can produce an hallucination, vision near death or actual death experience are different, however, they each result in the cause/effect chain of events in hypoxia – which is probably the main cause of the effects.
- Chloroquine, for example, can cause hypotension which can lead to hypoxia
- Primaquine causes methemoglobinemia in all patients who take it. Methemoglobin is an oxidized form of hemoglobin that can result in oxygen starvation to the brain - hypoxia.
The reason why Mefloquine causes hallucinations cannot be deduced with certainty because its mechanism of action is unknown. Its side effects, however, may contribute. Mefloquine can cause abnormalities with heart rhythms that are visible on an electrocardiogram. Combining mefloquine with other drugs that cause similar effects, such as quinine or quinidine, can increase these effects. In this case, the cause of the hallucinations could be heart related hypoxia.
The drug is sold as two enantiomers. According to some research, the (+)-enantiomer is more effective in treating malaria, and the (–)-enantiomer specifically binds to adenosine receptors in the central nervous system, and this too may account for some of its effects [see neurotransmitters – adenosine].
Ultimately the cause is Poisoning.
Observations
In the following descriptions, the number of hallucinations is shown in brackets by each drug. The figures were obtained from the eHealthme web site and compiled from SEDA and FDA statistics . I have provided a link to the drugs so that you can see all the side efects
Observation identifiers |
Observation name |
No of hallucinations |
001549 |
Larium and Jane Austin |
1 |
001550 |
2 |
|
001551 |
23 |
|
001552 |
Mefloquine [Lariam] |
217 |
018006 |
2 |
|
018846 |
1 |
|
019118 |
10 |
|
- |
214 |
|
019491 |
92 |
|
019512 |
18 |
|
015657 |
35 |
|
019988 |
2 |
|
|
TOTAL |
607 |
There are no figures on eHealthme for the following
- Pamaquine - is an 8-aminoquinoline drug used for the treatment of malaria. It is closely related to primaquine.
- Tafenoquine - (also called WR 238605 or SB-252263) is an 8-aminoquinoline drug that is currently being investigated as a potential treatment for malaria, as well as for malaria prevention. The main advantage of tafenoquine is that it has a long half-life and therefore does not need to be taken as frequently as primaquine.
In order to provide a contrast, we have also included some plant based healing treatments. All these are to be found under the malaria heading as well, but we thought it might be useful as a contrast, to show that there are many many local plants that have been used effectively for millenia by each population, that if we are going on holiday to a region might be used effectively. Needless to say, the local population have no need for expensive pharmaceuticals, as they already have the local plant treatments, as long as they use them!
Related observations
Healing observations
- Activity of Herbal Medicines on Plasmodium falciparum Gametocytes: Implications for Malaria Transmission in Ghana 020983
- An account of the success of the Bark of the Willow in the Cure of Agues - Rev. Mr. Edmund Stone 1763 020518
- Anti-plasmodial activity of the extracts and two sesquiterpenes from Cyperus articulatus 020545
- Antimalarial activity of some Colombian medicinal plants 019355
- Antimalarial evaluation of the leaf latex of Aloe citrina and its major constituent 020985
- Antimalarial use of volatile oil from leaves of Virola surinamensis (Rol.) Warb. by Waiãpi Amazon Indians 018282
- Antiplasmodial activity of New Caledonia and Vanuatu traditional medicines 021403
- Antiplasmodial potential of traditional phytotherapy of some remedies used in treatment of malaria in Meru-Tharaka Nithi County of Kenya 019172
- Dr Duke's list of Chemicals and their Biological Activities in Pilocarpus microphyllus 018158
- Dr Duke's list of Chemicals and their Biological Activities in: Menyanthes trifoliata L. (Menyanthaceae) -- Bog Myrtle, Bogbean, Buckbean, Marsh Clover, Marsh Trefoil, Water Trefoil 018266
- Dr Duke's list of Chemicals and their Biological Activities in: Opopanax chironium (L.) KOCH (Apiaceae) -- Hercules All Heal, Opopanax 018264
- Dr Duke's list of chemicals having anti-malarial activity 018059
- Dr Duke's list of Plants with Antimalarial activity 018057
- Dr Duke's list of Plants with Antimalarial activity of high chemical potency 018058
- Dr Duke's list of Plants with Plasmodicidal activity 018296
- Dr Duke's list of Plants with Plasmodicidal activity of high chemical potency 018297
- Dr Duke's list of the Biological Activities of RUTIN 018281
- Dr Duke’s list of Antiparasitic Activities in: Ailanthus altissima -- Stinktree, Tree Of Heaven 018308
- Effective malaria treatments in Brazil 012745
- Extent of Use of Aloe vera Locally Extracted Products for Management of Ailments in Communities of Kitagata Sub-county in Sheema District, Western Uganda 020986
- Folk phytotherapeutical plants from Maratea area (Basilicata, Italy 019478
- Larvicidal effect of aqueous and ethanolic extracts of Senna alata on Anopheles gambiae, Culex quinquefasciatus and Aedes aegypti 021420
- New findings on Simalikalactone D, an antimalarial compound from Quassia amara L 019148
- Simalikalactone D is responsible for the antimalarial properties of an amazonian traditional remedy made with Quassia amara 019146
Hallucination
- Aralen 018006
- Chloroquine 001550
- Clindamycin phosphate 018211
- Daraprim 018846
- Hydroxychloroquine Sulfate 019118
- Larium and death 005521
- Malaria treatments, psychoses and anorexia 012798
- Malarone 019491
- Mefloquine violence and psychosis 005247
- Mefloquine [Lariam] 001552
- Mepron 019512
- Plaquenil 015657
- Primaquine 001551
- Qualaquin 019988
- Qualaquin, Quinine sulphate and Quinine medication use and abuse 024135