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Malaria Journal
Published in: Malaria Journal 1/2018

Open Access 01-12-2018 | Review

Adjunctive therapy for severe malaria: a review and critical appraisal

Authors: Rosauro Varo, Valerie M. Crowley, Antonio Sitoe, Lola Madrid, Lena Serghides, Kevin C. Kain, Quique Bassat

Published in: Malaria Journal | Issue 1/2018

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Abstract

Background

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.

Results and conclusions

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.
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Metadata
Title
Adjunctive therapy for severe malaria: a review and critical appraisal
Authors
Rosauro Varo
Valerie M. Crowley
Antonio Sitoe
Lola Madrid
Lena Serghides
Kevin C. Kain
Quique Bassat
Publication date
01-12-2018
Publisher
BioMed Central
Published in
Malaria Journal / Issue 1/2018
Electronic ISSN: 1475-2875
DOI
https://doi.org/10.1186/s12936-018-2195-7

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