Comparison of methods of malaria control

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This page is a comparison of methods of malaria control, covering methods of both prevention and treatment.


Drug Methods

Use of insecticides has two main variables: method of delivery and the insecticide itself. This table covers the former; the latter are numerous and are covered separately in a second table below.

Type := Prevention | Treatment | Both

ACT (artemisinin combinatorial therapy) -- different from artenisinin?

also "comprehensive surveillance" gets mentioned a lot, in the course of using the other things.

Chemoprophylaxis -- which drugs are included?

consider "patient compliance" as a column

include various Artemisinin-based combination therapies (ACTs)

Method Type Acts against Route of administration First use First resistance Locations where used Advantages Disadvantages Combines with Status
Amodiaquine Treatment "some chloroquine-resistant strains, particularly Plasmodium falciparum"[1] oral[2] 1951[3] 1971[3] Africa Absorption is not influenced by food (compared with partner drug lumefantrine which should be taken with fatty food).[4] "Formation of toxic amodiaquine quinone imine (AQQI) metabolites"[5] Artesunate WHO Essential Medicine
Artemether Treatment[6] "Acute uncomplicated malaria."[6] Oral[7], intramuscular injection[8] 1987 Complementary advantage with lumefantrine. "Artemether has an initial burst effect on Plasmodium schizonts and a variety of drug-resistant malaria strains."[9] Lumefantrine WHO Essential Medicine
Artemisinin Treatment Plasmodium falciparum oral, intramuscular, rectal[10][11] 1970s[3] 1998[3], 2009[12] Safe antimalarial in pregnancy.[13] More expensive than SP or chloroquine.[14]:165
Artemotil Treatment "Rapidly against Plasmodium during the early blood stage of its development. It also shows gametocytocidal activity against Plasmodium falciparium."[15] "Intramuscular injection only."[16] 2000 [17] "Excellent alternative to quinine, over which it has clear advantages: it causes a swifter decrease in parasite numbers; is simpler to apply; has far fewer undesirable side-effects." "Also has advantages in cases where the patient is not able to retain food (and thus cannot be treated with oral medication)."[17]
Artemether/lumefantrine Treatment Plasmodium falciparum
Artesunate Treatment 1996[18] Advantages over quinine: Acts rapidly. Causes faster clearance of parasite. It is better tolerated, more effective and more safe.[13]
Artesunate/amodiaquine Treatment[19] "Uncomplicated Plasmodium falciparum malaria, especially in paediatric patients"[19] Oral[20] 2007[21] Sub-Saharan Africa
Artesunate suppositories
Atovaquone-proguanil (Malarone) Treatment, prevention[22] Blood and liver phases of Plasmodium falciparum[23] Oral 1996[3] 2002[3] Found to be 95% effective in otherwise drug resistant falciparum malaria.[24]
Chloroquine Both "Intraerythrocytic Plasmodium falciparum stages"[25] Oral ~1940s (during WWII) 1957[26] Safer than quinine. Safe antimalarial in pregnancy.[13] "Low toxicity and cost" "high effectiveness".[27] Proguanil
Chlorproguanil-Dapsone Treatment "uncomplicated falciparum malaria"[28] "cheap, rapidly eliminated, more potent than pyrimethamine-sulfadoxine, and could be introduced in the near future to delay the onset of antifolate resistance and as "salvage therapy" for pyrimethamine-sulfadoxine failure."[28]
Clindamycin Treatment[29] Plasmodium falciparum[29] 1960s[29]
Dihydroartemisinin-Piperaquine (Artekin) Oral (pills)[30]
Doxycycline Treatment
Halofantrine Treatment "Introduced in the 1980s"[24] "Due to its short half life of 1 to 2 days, is not suitable for use as a prophylactic."[24] "Resistant forms are increasingly being reported and there is some concern about its side effects. Halofantrin has been associated with neuropsychiatric disturbances. It is contraindicated during pregnancy and is not advised to women who are breastfeeding. Abdominal pain, diarrhea, puritus and skin rash have also been reported."[24]
Intermittent preventive therapy
Lumefantrine (benflumetol) Treatment[16] "Multidrug resistant Plasmodium falciparum".[16] "Oral preparation coformulated with artemether."[16]
Mefloquine Both Plasmodium falciparum, Plasmodium vivax 1977[3] 1982[3]
Piperaquine Plasmodium vivax, Plasmodium falciparum[31] 1963[32]
Primaquine Treatment "Plasmodium vivax and plasmodium ovale."[16] "Gametocytocidal against plasmodium falciparum".[16] "The only antimalatial drug that is effective against exo-erythrocytic schizogony and is used for radical cure of Plasmodium vivax malaria."[13] "Hemolysis in patients with Glucose-6-phosphate dehydrogenase deficiency."[13]
Proguanil Both Plasmodium falciparum chloroquine, atovaquone
Quinine Treatment "asexual erythrocytic forms of malaria, including Plasmodium vivax, Plasmodium malariae and Plasmodium falciparum and is gametosidal to Plasmodium vivax and Plasmodium malariae."[33] <1700[34] 1910[3]
RTS,S Prevention Plasmodium falciparum
Trimethoprim-sulfamethoxazole Treatment[35]
Sulfadoxine/pyrimethamine (Fansidar) Treatment 1967[3] 1967 (same year it was introduced)[3] "cheap, practicable (only one dose is needed because it eliminates from the body slowly)"[3]

Non-drug Methods

Method Type Acts against First use Locations where used Advantages Disadvantages Status
Sulfonamide compounds
Exchange transfusion (ET) Treatment[36] Severe malaria[36]
Swamp draining Prevention Mosquito
Indoor residual spraying Prevention Mosquito "Large-scale IRS with DDT for malaria control started in 1946."[37] "A single spraying can protect a home for up to 9 months."[38] "Spraying requires no behavourial change – after spraying teams have treated a dwelling, the occupiers can continue as before."[38] "homes must be regularly resprayed for the treatment to remain effective over longer periods."[38]
Larviciding (application of insecticides to mosquito breeding sites)
Genetic blood disorders
Selective eradication of certain mosquito species
Use of decoys[39]
Personal protection (like long-sleeved clothing?)
Other forms of larval control?
Pyrethroid nets Prevention It has promoted resistance among malaria vectors in specific geographic areas.[40]
Mosquito coil Prevention Mosquito
Mosquito mat Prevention Mosquito
Mosquito net Prevention
Immunity from repeated infection Prevention Malaria (just P. falciparum?)


All insecticides act against mosquitoes and are used for prevention. (?)

Surface := Bednet | Wall | Swamp

Also consider the length the insecticide lasts (in different contexts)? For IRS, DCP2 p423 gives 6+ months for DDT, 3–6 months for lambda-cyhalothrin, and 2–3 months for malathion and deltamethrin.

Name Surface First use First resistance Locations where used Advantages Disadvantages Usage status
Dichlorodiphenyltrichloroethane (DDT) 1943[41]:7 1946[41]:9 Cheap, chemically stable, lipophilic (so not easily washed off)[41]:7 Persists in environment, accumulates along food chain[41]:7
Dihydrolipoamide dehydrogenase (DLD)
BHC (Lindane?)
Paris green

Carbamate insecticides

See also

External links


  1. "amodiaquine". Retrieved 24 April 2017. 
  2. "ARTESUNATE AMODIAQUINE WINTHROP 25 mg/67.5 mg, tablet" (PDF). Retrieved 24 April 2017. 
  3. 3.00 3.01 3.02 3.03 3.04 3.05 3.06 3.07 3.08 3.09 3.10 3.11 "Simpli fied R eversed C hloroquines t o Overcome M alaria Resistance to Quinoline-b ased D rugs". Portland State Universit y. 
  4. Turner, Arthur. Logan Turner's Diseases of the Nose, Throat and Ear, 10Ed. Retrieved 24 April 2017. 
  5. "Medicinal Chemistry of Antimalarial Drugs - PharmaFactz". Retrieved 24 April 2017.  External link in |website= (help)
  6. 6.0 6.1 "Artemether". OPEN CHEMISTRY DATABASE. 
  7. Pharmaceutical Product Development: Insights Into Pharmaceutical Processes, Management and Regulatory Affairs (Vandana B. Patravale, John I. Disouza, Maharukh Rustomjee ed.). Retrieved 25 April 2017. 
  8. "Essential Medicines and Health Products Information Portal". World Health Organization. 
  9. "Enhanced Antimalarial Activity by a Novel Artemether-Lumefantrine Lipid Emulsion for Parenteral Administration". doi:10.1128/AAC.01428-13. Retrieved 24 April 2017. 
  10. "The pharmacokinetics of artemisinin after oral, intramuscular and rectal administration to volunteers.". PMID 1982311. Retrieved 24 April 2017. 
  11. "Rectal administration of artemisinin derivatives for the treatment of malaria". Retrieved 24 April 2017. 
  12. "San Antonio scientist awarded $4.6 million for malaria research". 
  13. 13.0 13.1 13.2 13.3 13.4 Mondal, Sudeb. "Basic Undergraduate Pharmacology". 
  14. Dowling, John Malcolm; Yap, Chin-Fang (2014). Communicable Diseases in Developing Countries: Stopping the global epidemics of HIV/AIDS, Tuberculosis, Malaria and Diarrhoea. Palgrave and Macmillan. 
  15. "Artemotil". Retrieved 24 April 2017. 
  16. 16.0 16.1 16.2 16.3 16.4 16.5 Guidelines for the Treatment of Malaria. World Health Organization. 
  17. 17.0 17.1 "MALARIA: Artemotil treatment". Retrieved 26 April 2017. 
  20. Artesunate + Amodiaquine. 
  21. "New, Once-a-Day Fixed-Dose Combination Against Malaria Now Available". Retrieved 27 April 2017. 
  22. "Malarone". 
  23. "Malaria" (PDF). Retrieved 26 April 2017. 
  24. 24.0 24.1 24.2 24.3 "Malaria: Past and Present History of Treatment and Prophylaxis". 
  25. "dentification of a Chloroquine Importer in Plasmodium falciparum" (PDF). THE JOURNAL OF BIOLOGICAL C HEMISTRY. 
  26. "Chloroquine resistance". 
  27. Semba, Richard David; Bloem, Martin W. Nutrition and Health in Developing Countries. 
  28. 28.0 28.1 "Chlorproguanil-dapsone: effective treatment for uncomplicated falciparum malaria.". PMC 164103Freely accessible. 
  29. 29.0 29.1 29.2 "Clindamycin as an Antimalarial Drug: Review of Clinical Trials". Members of the AAC Editorial Board >> ASM Journal Press Releases Antimicrobial Agents and Chemotherapy. doi:10.1128/AAC.46.8.2315-2320.2002. 
  30. "Dihydroartemisinin + piperaquine (Inclusion) -- Adults and Children". WHO. 
  31. "Journal of Tropical Diseases & Public Health". Retrieved 26 April 2017. 
  32. "Randomized Trial of Piperaquine with Sulfadoxine-Pyrimethamine or Dihydroartemisinin for Malaria Intermittent Preventive Treatment in Children". Retrieved 26 April 2017. 
  33. "QUININE". 
  34. "Quinine, an old anti-malarial drug in a modern world: role in the treatment of malaria". doi:10.1186/1475-2875-10-144. 
  35. "Trimethoprim-sulfamethoxazole in the treatment of malaria, toxoplasmosis, and pediculosis.". PMID 7051240. 
  36. 36.0 36.1 "Exchange Transfusion for Severe Malaria: Evidence Base and Literature Review". Oxford Academic. 
  37. "Indoor Residual Spraying". 
  38. 38.0 38.1 38.2 "Malaria and Vector Control Question and Answers - IVCC". UNITAID. 
  39. "Malaria Site: History of Malaria Control". Retrieved December 20, 2016. 
  40. "ITNs: Challenges - Insecticide Resistance". 
  41. 41.0 41.1 41.2 41.3 Palmer, Michael (March 26, 2016). "The ban of DDT did not cause millions to die from malaria" (PDF). Retrieved December 22, 2016.