TRADITIONAL CHINESE MEDICINES FOR MALARIA THERAPY: A REVIEW

Abstract

Malaria, one of the “big three” killer diseases, is a major public health problem as well as a major cause of mortality and morbidity in the world. The goals of the global malaria elimination program are to (i) reduce malaria case incidence by at least 90% by 2030, (ii) reduce malaria mortality rates by at least 90% by 2030, (iii) eliminate malaria in at least 35 countries by 2030, and (iv) prevent resurgence of malaria in all countries that are malaria-free. Currently, the malaria elimination strategy mainly depends on chemotherapy, with the available antimalarials divided into five categories according to the chemical structure and mechanism of drug actions, namely, aryl amino alcohol compounds, 8-aminoquinolines, antifolate compounds, artemisinins, and other agents. Artemisinin, a sesquiterpene lactone extracted from the Chinese medicinal herb Artemisia annua, has been recommended as the first-choice treatment for malaria by the World Health Organization. However, the rapid emergence of artemisinin tolerance in Plasmodium falciparum has hasten the development of novel antimalarials towards global malaria elimination. The effectiveness and safety of traditional Chinese medicines for treatment of parasitic diseases, including malaria, have been recognized. Here, we review other traditional Chinese medicines that show potential for malaria treatment. Crude extracts and pure compounds from ginger, garlic, the Asteraceae family, Bupleuri radix and Daphne spp have shown in vitro and in vivo antiplasmodial activities, and some have been tested for their antimalarial actions in malaria patients. Further randomized, controlled clinical trials to examine the efficacy and safety of traditional Chinese medicines for treatment of malaria and to unravel their underlying mechanisms appear justified.