Adjunctive therapy for severe malaria: a review and critical appraisal

Despite recent efforts and successes in reducing the malaria burden globally, this infection still accounts for an estimated 212 million clinical cases, 2 million severe malaria cases, and approximately 429,000 deaths annually. Even with the routine use of effective anti-malarial drugs, the case fat...

Full description

Saved in:
Bibliographic Details
Published in:Malaria journal 2018-01, Vol.17 (1), p.47-47, Article 47
Main Authors: Varo, Rosauro, Crowley, Valerie M, Sitoe, Antonio, Madrid, Lola, Serghides, Lena, Kain, Kevin C, Bassat, Quique
Format: Article
Language:English
Subjects:
Adjunctive
Adolescent
Adult
Aged
Aged, 80 and over
Animals
Antimalarials - therapeutic use
Care and treatment
Cerebral
Child
Child, Preschool
Disease Models, Animal
Health aspects
Humans
Immune system
Immunomodulation
Immunotherapy
Infant
Malaria
Malaria, Cerebral - drug therapy
Malaria, Falciparum
Malària
Medical research
Medicine, Experimental
Mice
Middle Aged
Plasmodium falciparum
Review
Severe
Terapèutica
Therapeutics
Treatment
Young Adult
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Despite recent efforts and successes in reducing the malaria burden globally, this infection still accounts for an estimated 212 million clinical cases, 2 million severe malaria cases, and approximately 429,000 deaths annually. Even with the routine use of effective anti-malarial drugs, the case fatality rate for severe malaria remains unacceptably high, with cerebral malaria being one of the most life-threatening complications. Up to one-third of cerebral malaria survivors are left with long-term cognitive and neurological deficits. From a population point of view, the decrease of malaria transmission may jeopardize the development of naturally acquired immunity against the infection, leading to fewer total cases, but potentially an increase in severe cases. The pathophysiology of severe and cerebral malaria is not completely understood, but both parasite and host determinants contribute to its onset and outcomes. Adjunctive therapy, based on modulating the host response to infection, could help to improve the outcomes achieved with specific anti-malarial therapy. In the last decades, several interventions targeting different pathways have been tested. However, none of these strategies have demonstrated clear beneficial effects, and some have shown deleterious outcomes. This review aims to summarize evidence from clinical trials testing different adjunctive therapy for severe and cerebral malaria in humans. It also highlights some preclinical studies which have evaluated novel strategies and other candidate therapeutics that may be evaluated in future clinical trials.
ISSN:1475-2875
1475-2875
DOI:10.1186/s12936-018-2195-7