A prophylactic antimalarial drug that is both effective for protection and improves compliance is in high demand.
Malaria drugs chloroquine and hydroxychloroquine are currently being evaluated in a number of clinical trials as active treatments against SARS-CoV-2 virus. They are also postulated for pre and postexposure prophylaxis for the prevention of COVID-19. It has been recently shown that both molecules inhibit in-vitro the entry of the virus in the cell, and they can stop the cytokine storm derived from the infection alongside impeding T cell activation [1,2]. In particular, hydroxychloroquine is a drug with an excellent safety profile, even for pregnant women. Furthermore, hydroxychloroquine has been successfully used during decades for the management of rheumatologic diseases modulating inflammation and organ damage .
Ivermectin is safe and widely used for treating helminth infections. It also kills arthropods feeding on treated subjects, including malaria vectors. Thus, ivermectin mass drug administration as an additional tool for malaria control is being evaluated by WHO. As in vitro data, animal experiments and epidemiological observations suggest that ivermectin has a direct effect on the liver stages of the malaria parasite, this study was designed to assess the prophylactic effect of ivermectin on Plasmodium falciparum controlled human malaria infection.
The British Army adopted mefloquine (Lariam) as its preferred drug for chemoprophylaxis against malaria in 1993. Treatment doses of mefloquine had already been reported to cause an acute brain syndrome. In 1996, army doctors reported a private soldier who, after six doses of mefloquine prophylaxis, saw the Grim Reaper standing behind the chaplain, heard incoherent voices, and was admitted to a psychiatric hospital; more reports followed.
The effectiveness of malaria chemoprophylaxis is limited by a lack of compliance in travellers. This study assesses the demographic, travel-related, and psychosocial determinants of non-compliance with chemoprophylaxis.
This expert blog was contributed by Dr. Merlin Willcox, Honorary Secretary of the Research Initiative on Traditional Antimalarial Methods (RITAM), in response to the outcome of a poll on MalariaWorld and recent contributions regarding the use of Artemisia tea as a remedy for malaria.