Evaluating a Potential Cure for Malaria with LC-MS

The World Health Organization (WHO) state that malaria afflicted 228 million people in 2018 with over 400,000 deaths. The region most affected by malaria is sub-Saharan Africa - but there are cases of malaria across the globe. There are many different strategies involved in the fight against malaria including vector control, vaccination and treatment of the disease.

A recent paper published in Malaria Journal discusses work carried out by researchers in Guinea in West Africa into the anti-malarial effects of Terminalia albida - a tree species found in West Africa and used in traditional medicine. With increasing resistance to current treatments researchers are exploring many new options in the search for an effective malarial treatment - and plant-based treatments are just one option they are investigating.

The curse that is malaria

The incidence rate for malaria decreased over the last decade - but the rate of change is slowing down. Almost 93% of malaria cases were in sub-Saharan Africa, followed by 3.4% in South-East Asia and 2.1% in the Eastern Mediterranean region. The number of deaths from malaria is slowly decreasing too - down from 585,000 in 2010 to approximately 405,000 in 2018.

 Changes in the sleeping habits of people in sub-Saharan Africa could be a contributing factor in the decrease in incidence and death from malaria - over 50% of the population now sleep under an ITN (insecticide-treated mosquito net) compared to only 29% in 2010. The number of households with access to an ITN has not increased significantly over the last 3 years though.

Treating malaria - can new plant-derived treatments work?

There are a few treatments for malaria, and these are derived from artemisinin, a compound isolated from the plant Artemisia annua - a herb used in Chinese medicine known as sweet wormwood. Unfortunately, Plasmodium falciparum - the most prevalent malaria parasite in sub-Saharan Africa and South East Asia - has developed resistance to artemisinin and its derivatives known as ACTs (artemisinin-combination therapies).

The development of new treatments is urgently required and researchers in Guinea, West Africa have investigated the properties of a plant from the region known as Terminalia albida. Using liquid chromatography-mass spectrometry (UHPLC-HRMS) they identified 12 bioactive compounds. The use of chromatography to screen for drug compounds is discussed in the article, Screening of Western Drug Adulterants in Complementary Health Products by High Performance Liquid.

The research team in Guinea conducted both in vitro and in vivo studies into the action of T. albida on malaria. In vivo, they discovered that the plant extracts greatly increased the survival rates of infected mice and also reduced the number of parasites in infected blood. However, before treatment with the plant can be recommended, further investigations are needed into the long-term toxicity and effects of the plant as well as the antiparasitic mechanisms used.