Biology Reference
In-Depth Information
methylene blue also turns urine and other body fluids blue temporarily, so
those receiving the drug need to be warned to avoid unnecessary alarm.
7.3. Other Medications Still in Pre-clinical Stages
Better drugs capable of killing all phases of plasmodium's life-cycle are
needed which includes parasites in the blood, liver and mosquito. Tradi-
tionally, this has meant 8-aminoquinolines and perhaps tafenoquine can be
adapted to fit a public health indication such as MDA for elimination. Cer-
tainly tafenoquine is the only new drug that is already in advanced clinical
testing, which might possibly be adapted for MDA. New molecular classes
of antimalarial drugs to block transmission and kill hypnozoites are needed
urgently. A least one of the discovery projects sponsored by the Medicines
for MalariaVenture (
www.mmv.org
)
is a new class of compounds described
as imidazolidinediones that kill liver parasites in a non-human primate
model (
Guan et al., 2007
;
Meister et al., 2011
). Early investigations of such
compounds are promising, but one must always be aware of the number
of drugs which fall by the wayside because of a variety of pharmacologi-
cal problems (
Meister et al., 2011
;
Derbyshire et al., 2011
;
Borrmann and
Matuschewski, 2011
). One can certainly hope that some of the promising
new compounds will eventually make it out of the laboratory and into
clinical testing, but even with a decades-long view of malaria elimination, it
is unlikely that completely new drugs will play a role in malaria elimination
for many years to come.
8. PROSPECTS FOR IMPROVED ANTI-TRANSMISSION
MEASURES
Despite the great progress that has been achieved in many countries
using established control methods, malaria elimination will almost certainly
require new interventions, especially in areas with year-round transmission
(
Chanda et al., 2011
). The danger in this realization is that waiting for a
perfect solution negates the progress that can be achieved now with ITN,
IRS and case finding with effective drug therapy. Research on new antima-
larial solutions is required in order to respond to a plastic parasite known to
be capable of evolutionary change to thwart control/elimination programs
(
mal ERACGoVC, 2011
). When GMEP ran into problems, there were no
alternatives that had already been developed such that the program col-
lapsed as donors realized that quick success could not be achieved (
Brown,
1998
). It is important that current demands are balanced against future
