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Malaria therapy Issues, Challenges & opportunities
Topics for discussion ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Background of Malaria today Analysis
Types of malaria Malaria Vivax Falciparum Plasmodium vivax Plasmodium falciparum Morbidity Mortality Plasmodium
Burden of malaria ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],~ 1 deaths ~ 5 severe cases ~ 500 clinical cases ~ 5,000 febrile episodes Numbers in millions
Spread of malaria ,[object Object],[object Object],[object Object],[object Object],[object Object]
Lifecycle of Malaria A close understanding
Cycle of malaria
Cycle of malaria
Cycle of malaria
Cycle of malaria
Cycle of malaria
Cycle of malaria
Cycle of malaria
Cycle of malaria
Cycle of malaria
Complications of falciparum Malaria An in depth perspective
Why is falciparum dangerous ? ,[object Object],[object Object],Pathogenesis Of malaria Circulatory Immunological Metabolic Cytokines Adhesion Cytokines Humoral Vasoactive Enzyme defects
Why is falciparum dangerous ? ,[object Object],[object Object]
Why is falciparum malaria fatal ? ,[object Object],[object Object],[object Object],[object Object],[object Object]
14 Complications of malaria ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Case management ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Problems of Malaria therapy today Globally
Control strategies Strategies for  control of malaria Vector control Preventive treatment Case management Epidemic response
Choice of therapy Choice of antimalarials Safety Costs Ease of use
Choice of antimalarials
Resistance to Chloroquine Countries with at least one study indicating chloroquine total failure rate  >  20% No recent data available Countries with at least one study indicating chloroquine total failure rate  >  10%
Resistance to SP Countries with at least one study indicating sulfadoxine-pyrimethamine total failure rate  >  20% No failure reported Sulfadoxine-pyrimethamine total failure rate < 10% No recent data available Countries with at least one study indicating sulfadoxine-pyrimethamine total failure rate  >  10%
Consequences of resistance ,[object Object],[object Object],[object Object],[object Object]
Slowing resistance emergence ,[object Object],[object Object],[object Object],[object Object]
Therapy issues in malaria Uncomplicated malaria Severe malaria ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Recommendations in Malaria therapy Current
Current therapy recommendations ,[object Object],[object Object],[object Object],[object Object]
What is ACT ? ,[object Object]
Why ACT? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Why ACT? ,[object Object],[object Object],[object Object],[object Object],0 1 2 week artemisinin level partner level parasitemia
What are Artemisinins ? Artemisinin derivatives Qinghaosu  (&quot;ching-how-soo&quot;)  Methyl Ether Hemisuccinate Ethyl Ether Arteether Artesunate Artemether Dihydroartemesin
What are Artemisinins ? Qinghaosu  (&quot;ching-how-soo&quot;)
Why Artemisinins ? ,[object Object],[object Object],Recrudescence : a return of malaria after a period of abatement
Why Artemisinins ? ,[object Object],[object Object],[object Object],[object Object]
Why Artemisinins ? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
WHO recommendations ,[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object],[object Object],[object Object],[object Object],WHO recommendations
AL in Malaria therapy Artemether - Lumefantrine
Artemether-Lumefantrine (AL) ,[object Object],[object Object],[object Object]
Artemether-Lumefantrine (AL) ,[object Object],[object Object],[object Object]
Artemether-Lumefantrine (AL) ,[object Object],[object Object],[object Object]
The background ,[object Object],[object Object]
Mechanism of action ,[object Object],[object Object],[object Object],[object Object]
Results of action ,[object Object],[object Object]
Absorption ,[object Object],[object Object],[object Object],[object Object]
Distribution ,[object Object]
Metabolism ,[object Object],[object Object],[object Object],[object Object]
Elimination & excretion ,[object Object],[object Object],[object Object]
Artemether-Lumefantrine  (AL - studies) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Artemether-Lumefantrine (AL) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Fast parasite elimination ,[object Object],[object Object],[object Object],[object Object]
Fast parasite elimination ,[object Object],[object Object]
Fast parasite elimination
Fast parasite elimination
Fast parasite elimination
Artemether-Lumefantrine (AL) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Prompt reduction in fever ,[object Object],[object Object],[object Object]
Prompt reduction in fever
Artemether-Lumefantrine (AL) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Effective gametocyte clearance ,[object Object],[object Object],[object Object],[object Object],[object Object]
Effective gametocyte clearance ,[object Object]
Effective gametocyte clearance
Artemether-Lumefantrine (AL) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Cure rates ,[object Object],[object Object]
Cure rates
Cure rates
Artemether-Lumefantrine (AL) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Safety and tolerability ,[object Object],[object Object],[object Object]
Safety and tolerability
Safety and tolerability
Safety and tolerability
Safety and tolerability
Dosage ,[object Object]
Current therapy packs of AL Pack shot
Warning ,[object Object],[object Object],[object Object],[object Object]
AL essentials ,[object Object]
Summary of Lumether  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Summary of Lumether ,[object Object],[object Object],[object Object],[object Object]
Knowing more in Malaria therapy Beyond Artemether - Lumefantrine
What to give in pregnancy ? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Artemisinins parenteral ,[object Object],[object Object],[object Object]
Quinine parenteral ,[object Object],[object Object],[object Object],[object Object],[object Object]
Intermittent Presumptive Therapy  (IPT)  & Mass Drug Administration  (MDA) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
New drug possibilities ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
The time of cheap, poorly effective antimalariafor the poor is over The time is now, for highly effective antimalarials at an affordable price for the poor
Amalar-XL From B&B

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