Antimalarials

The Battle Against Malaria: A Historical Tale

In the late 19th century, malaria was one of the deadliest diseases on the planet, killing millions across Africa, Asia, and South America. The cause of the disease remained a mystery until 1880, when a French army doctor named Alphonse Laveran, working in Algeria, discovered parasites in the blood of malaria patients. This was the first time a protozoan was identified as the cause of disease in humans.

A few years later, in 1897, British doctor Ronald Ross made a groundbreaking discovery. While working in India, he confirmed that malaria was transmitted by the Anopheles mosquito, solving a puzzle that had baffled scientists for centuries. This revelation sparked a global campaign against mosquitoes, from draining swamps to spraying insecticides.

The next big leap came during World War II, when soldiers in the Pacific were dying more from malaria than bullets. The Allies turned to science, and chemists developed chloroquine, a synthetic anti-malarial drug. It was a game-changer—cheap, effective, and easy to produce.

Later, the world witnessed the development of artemisinin, a compound derived from the sweet wormwood plant, discovered by Tu Youyou in China during the 1970s. Her work, rooted in traditional Chinese medicine, saved millions of lives and earned her a Nobel Prize in 2015.

The battle isn’t over yet, but the history of anti-malaria efforts is a testament to human resilience, scientific curiosity, and global cooperation. 

Chloroquine is an antimalarial and anti-inflammatory drug with several clinical uses. Its main indications include:

1. Malaria Treatment and Prophylaxis

Treatment of malaria caused by Plasmodium vivax, P. ovale, P. malariae, and sensitive P. falciparum strains.

Prophylaxis (prevention) of malaria in regions where chloroquine resistance is not present.

2. Extraintestinal Amebiasis

Used as part of combination therapy to treat hepatic amebiasis (liver abscess caused by Entamoeba histolytica), not effective for intestinal infection.

3. Autoimmune Diseases (anti-inflammatory effect)

Rheumatoid arthritis (RA) – as a disease-modifying antirheumatic drug (DMARD)

Systemic lupus erythematosus (SLE) – especially for skin and joint symptoms 

Precautions:

1. Liver or kidney disease – dose adjustment may be needed.

2. G6PD deficiency – risk of hemolysis with drugs like primaquine.

3. Pregnancy – some drugs (e.g., doxycycline) are not safe.

4. Heart issues – drugs like quinine and chloroquine can affect heart rhythm.

5. Psoriasis or porphyria – may worsen with chloroquine or hydroxychloroquine.

6. Eye problems – long-term use of chloroquine/hydroxychloroquine can harm the retina.

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Contraindications:

1. Allergy to the drug.

2. G6PD deficiency – contraindicated with primaquine.

3. Severe liver or kidney impairment – some drugs are avoided.

4. Pregnancy – avoid doxycycline and primaquine.

5. Epilepsy – avoid mefloquine (can trigger seizures).