Exploring Malaria Treatment Regimes: Oral vs. Vaccine, Risks & Benefits Case Study

Exploring Malaria Treatment Regimes: Oral vs. Vaccine, Risks & Benefits

Introduction: Exploring Malaria Treatment Regimes: Oral vs. Vaccine, Risks & Benefits

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Infectious diseases are considered as the disease that are generally caused by means of microorganisms including bacteria, parasites, protozoa and viruses. An infectious disease is explained as an illness that is caused due to a pathogen or its toxic product which arises by means of transmission from an infected person to a healthy person. The prime aim of a charity is to overcome the threats that the people usually face from infectious diseases and to make the community aware regarding the threats that are caused due to the infectious disease. In this report, a parasitic infectious disease is being studied in detail and focus is being made in its treatment regimes.

Malaria is being studied here, due to the action of single-celled parasites of the genus plasmodium. There the causal organism that is responsible for causing malaria is Plasmodium Vivax and even other species of Plasmodium. The infection is being transmitted to humans by means of mosquito bites. Malaria is considered to be a mosquito borne parasitic infection usually spread by means of female anopheles mosquito. The plasmodium parasite that is responsible for causing malaria is neither considered to be a “virus” nor a “bacteria” but it is a “single-celled parasite” that usually replicate within the “red blood corpuscles of humans” as well as within the “intestine of the mosquito” (Rajvanshi et al. 2021). When the female mosquito feeds over an infected person, both the males and the females forms of parasite are being ingested within the human blood. The treatment of malaria is dependent upon its severity and it is also evident that if the malarial infections are being recognized at its early stage then it can be completely cured. The treatment for Malaria by means of vaccines are currently being developed such as RTS, S/AS01 vaccines and PFSPZ vaccines are considered to be the most promising malaria vaccines that are considered to be effective in recent dates (McKinney et al. 2020).

Treatment regime related to malaria

Malaria is regarded as an acute febrile illness that is being spread by means of causative agent termed as plasmodium being transmitted by the action of bites from the female anopheles mosquito. The treatment regimen for malaria is highly dependent upon the severity it causes. As per the views of Rajvanshi et al. (2021), malaria is mainly treated by means of prescribed drugs in order to kill the action of parasites within the human red blood cells. The type of drugs and the length of treatment is dependent upon the severity of infections that are present within the red blood cells of the infected person. As per the opinion of Herrador et al. (2019), individuals who are diagnosed with malaria are either undergoing through severity and who are not in case of complications are categorized under two different groups. The severity of the infections is also dependent upon the species that is infecting.

As per the views of Ashley and Poespoprodjo (2020), it is thought to be important to check if a person who is developing malaria was taking the medicine for malaria chemoprophylaxis or not. In this instance, the medicine combination utilised for prophylaxis was not part of the treatment for the specific disease, until all other choices were exhausted. The patient's clinical and parasitological state needs to be evaluated after the start of the treatment given to the patient. Therefore, it can be taken under consideration that the treatment that is required for preventing the serious threats of Malaria is oral treatment. The preferred oral drug used for the interim treatment of malarial infections includes the intake of "artemether-lumefantrine (Coartem®)" because of their rapid action against infection. "Atovaquone/Proguanil, Malarone and Doxycycline" are all the three prescribed that are recommended to intake in order to get rid of the serious threat of infections of malaria (Cohee et al. 2020).

Individuals traveling across the areas where Malaria is more common must ensure oral intake of the prescribed drugs. It is also recommended that both the adults and children who are suffering from malaria infection must take one dose of doxycycline each day starting from the initial day when the infection is being administered. Therefore, it is clear that the application of antibiotics in the context of malaria therapy usually represents a potential target due to the indispensability for malarial parasites. According to Anto et al. (2019), the majority of antibiotics typically result in a delayed death phenotype, which is what causes antimalarial activity to reveal itself late in the second cycle of pathogen replication. In addition to that, doxycycline is an antimalarial drug that is mainly used in order to get prevention from malaria. It is mainly available in an oral liquid formulation and is considered to have a significant effect on the infection that is caused in the red blood cells of the infected person. Moreover, Azithromycin is also considered to be an antimalarial drug that has shown a significant antimalarial activity in vitro as well (Cohee et al. 2020). Therefore, it is evident that the utilization of the oral antimalarial drug is considered to be the most effective treatment that is taken under consideration during the malarial treatment.

Analysis of the different mode of treatment for Malaria

Oral treatment of malaria

While analyzing the different modes of treatment for malaria it is being evident that the oral treatment is more effective as considered rather than any other modes of treatment that are provided to the infected individual (Kotepui et al. 2020). Antibiotics that are interested within the blood usually enhance the susceptibility of the anopheles mosquito by disturbing their gut microbiota. In the diagnosis of malarial infection an antibiotic is mainly prescribed to the infected person. Amoxicillin, an antibiotic that is being implemented for malaria but it does not have any antimalarial properties. World health organization (WHO) usually do not go for routine antibiotic treatment in case of uncomplicated malaria. Malaria as well as pneumonia are present with similar clinical signs that includes fever which often results in diagnosis and the treatment for both the conditions. Following the WHO guidelines, it can be recommended that antibiotic treatment is much more effective in case of malarial treatment.

It is evident that nearly “one million people” die just because of severe Malaria every year. In recent years, artemisinin based therapies are being used and it has become the backbone of the treatment in case of complications in the malarial infection (van Eijk et al. 2019). Since, the antimalarial drug resistance is increasing rapidly, therefore there is a rapid need for the combination treatment for malaria in order to reduce the death rate from one million every year. Azithromycin is referred to as a macrolide antibiotic that is primarily responsible for acting as an antimalarial drug and is incorporated within the children and the pregnant woman as this drug is considered to be very much effective in combating the infections.

Vaccine treatment for malaria

A malaria vaccine is considered to be a vaccine that provides immunization against the serious threats of parasitic infections and is used to get prevention from malaria. The only approved malaria vaccines are RTS, S, usually referred to or identified under the brand name of Mosquirix. As per the recent survey made in April 2022, it is being prevalent that the vaccine has been inoculated to nearly one million children who are dwelling in the areas with moderate to high malaria transmission (Hounkpatin et al. 2019). It mainly requires at least three doses that are given in case of infants who belong to the age group of 2 years additionally with a fourth dose that are providing protection for the another one to two years.

Mosquirix is the only approved malaria vaccine that is being approved and is widely used. It mainly requires at least three doses inoculated within the children. The injection of the vaccine is considered to have a significant reduction from hospital admission and at the same time it is also responsible for reducing the severity of the infections of malaria. The P. falciparum protein, which makes up the majority of Mosquirix, is thought to be a recombinant vaccine that primarily prevents the invasion of hepatocytes and also makes it possible for the infected hepatocytes to be destroyed. Due to its weak immunogenicity, the CSP vaccination frequently created an issue during the testing stage. By fusing the protein with the surface of the hepatitis B antigen, the concerned vaccination has attempted to prevent these while also producing a more immunogenic and effective vaccine that is offered to those who have an infection in their red blood cells. Infection is usually reduced by means of inducing high antibody that are also responsible for blocking the parasite from infecting the liver (Shafkat et al. 2021). The concerned antimalarial vaccine is considered to offer a modest protection against both the clinical as well as the people who are having a serial malarial infection especially the people who are belonging to the group of infancy.

Evaluation of the various treatments used to combat infection

In order to combat malaria infection it is very important to diagnose malaria and consult the doctor with the medical history and undergo a certain blood test in order to understand the severity of the infection caused by the concerned parasite. As per the opinion of Angrisano and Robinson (2022), the responsible blood tests are indicative to check the presence of parasites causing infections within the infected person in order to confirm the severity of the infection caused in the red blood corpuscles. Additionally, there are different genus for malarial parasites and the symptoms for different genus are different therefore the indicative blood test is also responsible to understand which genus has infected the person and what are the symptoms that they are going through. Blood test is also responsible for getting a better view of the infection caused by the parasite and that is resistance to certain anti parasite drugs. Moreover, it is also indicated to check whether the disease is causing any serious complications within the infected person or not.

Malaria can be treated by means of prescription of drugs in order to kill the parasitic action within the infected person's blood. As per the opinion of Arzika et al. (2019), the types of drugs and the length of treatment that will be offered to the infected person will carry by having a dependence over the different types of malarial parasite, the severity of the symptoms caused in the infected person's blood, the age to which the person is belonging and whether the patient is pregnant or not. The most common medicines in forms of antimalarial drugs that are offered to the person suffering from Malaria are “Chloroquinephosphate and Artemisinin-based combination therapies”. Chloroquine is regarded as the preferred treatment for any kind of parasite that is sensitive to the drug that the parasites are resistant to and therefore the drug is no longer providing any sort of effective treatment to the patients who are suffering from the serious threats of malaria. On the other hand, ACT is also a combination of two or more drugs that works against the malarial parasite in different significant ways. ACT is considered to be a preferred treatment applicable for chloroquine resistant malaria.

The first line treatment that is being offered to the patient against malarial infection is chloroquine and the second one that is also considered to be effective in this case is ACT Combination (Wilairatana et al. 2019). As per the guidelines offered by WHO, the multiple malarial guidelines will include the addition of new molecules for the treatment of malaria that are not much complicated as well as the optimization of the dosage regime for the anti-relapse treatment by means of inoculation of the antimalarial medicines in case of special risks population and even it is offered to the patients including the woman who are pregnant as well.

Risks and side effects of the treatment offered

Though there are certain benefits that are highly associated with the intake of the oral drug in the treatment of malaria, there are still certain risk factors that are responsible for the treatment of the ill effects of malaria. For instance, the side effects that are associated with the treatment of Malaria and the daily intake of malarial drugs includes headache, abdominal pain, nausea and diarrhea. As per the views of Mbanefo and Kumar (2020), the major complications that are highly associated with the individuals who are undergoing through the major complications of malarial parasite include “cerebral malaria, acute renal failure, pulmonary edema, severe anemia, and/or bleeding”. “Acidosis and hypoglycemia” are the two most common metabolic complications that are highly associated with the severity of the malarial infection. Intake of the antimalarial drug on a daily basis as a regular drug often leads to vivid dreams, hallucinations, changes in the sleep cycle and many more (Cohee et al. 2020).

In addition to that, some approved antimalarial medications are also responsible for liberating certain mild liver enzymes and the patients who are suffering from the ill effects of anti-malarial infection can experience difficulties in interpreting trial results. As per the opinion of Marques-da-Silva et al. (2020), dysfunction within the functioning of the liver can arise due to the currently undergone antimalarial therapies that is either by means of treatment through the malarial prophylaxis or as a cause of other treatments. Chloroquine is a useful dark that is mainly used for the treatment of malarial infection and has not been found because of liver toxicity and is considered to be safe in mild liver diseases as well. Moreover, the impact of malaria and antimalarial and their action as liver enzyme has been still kept unclear but the drug development has shown conflicting results that can cause abnormalities in the liver resulting in dysfunction of the liver. Anyone within the society can get affected by the seriousness of malaria and the cases of malaria are frequent mainly to the malaria transmission countries (Duffy and Patrick Gorres, 2020). Moreover, the vaccinations that are given to treat malaria are known to have side effects, including fever, soreness, and edema at the injection site. Similar negative side effects have been reported following other pediatric vaccinations. There is an increased risk of febrile seizures linked to the vaccination within 7 days of administration (Walk et al. 2019).

People usually from the countries with no malaria can also become infected while they are traveling to countries with malaria or by means of blood transfusion from an infected person to a healthy person. Plasmodium falciparum is the type of malaria that is considered to be more severe and it is even considered as a life-threatening malaria. People who are highly exposed by means of this species are more likely to impose the life-threatening risk and it is more common in South African countries near the Saharan desert (Kakuru et al. 2019). People with low immunity or no immunity are susceptible to acquire the ill effects of malaria, likely the young children or the pregnant woman or the individual who are traveling with no malaria but they are traveling and acquiring it. As an example, Malaria is not a threat for tropical and subtropical countries like the UK but it is an imported disease that is transmitted by means of bites from the anopheles mosquitoes in the tropical as well as in the case of the subtropical regions of the world.

Evaluation of the health benefits to patients

On a global scale, malaria is regarded as one of the most serious public health issues. Since small children and expectant women have low vaccination response rates, it is believed to be a main cause of death and disease in the majority of impoverished nations. As per the views of Yang et al. (2020), malarial infection imposes a substantial cause to both the individuals and their respective governments therefore a proper treatment therapy in order to reduce the seriousness of the diseases are needed to be considered in order to provide and ensure better health promotion in the entire world.

Health concerns regarding the prevention from malaria infection can even bring reduction in the costs of individuals as well as reduction in the family costs that involve the purchase of drugs needed in the treatment of malaria. The RTS, S malaria vaccine is considered to be the first vaccine that is being developed after undergoing a significant research and development and it took nearly 35 years, making it the first vaccination ever made against a parasite disease (Walker et al. 2020). The vaccine offers defense against Plasmodium falciparum, the kind of malaria that is most prevalent in Africa and responsible for the worst cases worldwide.

Conclusion

From the above study, it is therefore concluded that the Malaria is disease that is mainly caused due the parasite infection and it causes life threatening risks to the one those who are having low immunity against the disease. The study had also identified that malaria is not an origin of UK but it is imported to UK. Blood tests are also helpful in determining whether a parasite infection is resistant to some anti-parasitic medications. Additionally, it is advised to determine whether the infection is leading to any severe problems in the afflicted person. From the study it is also evident that the first line of defense against malarial infection is chloroquine, and the second line, which is also thought to be successful in this situation, is ACT Combination. In accordance with the recommendations made by the WHO, the multiple malarial guidelines will call for the addition of new, less complex molecules for the treatment of malaria as well as the optimization of the dosage regimen for the prevention of relapses through the administration of antimalarial drugs via inoculation in patients, including expectant women. In addition to that there are certain health benefits as well as the risks factors that are being associated with the parasitic disease and the symptoms that are often evident due to the regular intake of the malarial drug. The study on the other hand after undergoing the comparison had also presented that the oral treatment is considered to be more effective rather than undergoing any sort of therapies as it had certain health risks that can even lead to death. 

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