Muhammad Qasim Qureshi  ( 4th Year MBBS Student, King Edward Medical University, Lahore, Pakistan. )
Muhammad Khawer  ( 4th Year MBBS Student, King Edward Medical University, Lahore, Pakistan. )
Muneeb ur Rehman  ( 4th Year MBBS Student, King Edward Medical University, Lahore, Pakistan )

DOI: 10.47391/JPMA.7763
 

Madam, malaria is a parasitic infection that is one of the leading causes of death in developing countries like Pakistan. According to WHO, an estimated 241 million malaria cases were reported in 2020¹. Vaccines have been developed to prevent malaria but with limited efficacy.

Using next-generation antibodies can be a possible option to reduce malarial infection. Recently, a phase 1 trial conducted by NIAID at the National Institute of Health (NIH), USA, clinical centre has reported promising results with using intravenous and subcutaneous antibodies for malaria prophylaxis in healthy adults².

Chemoprophylaxis drugs like chloroquine, mefloquine, and atovaquone/proguanil has been used for malaria in Pakistan, but it has led to the generation of drug-resistant strains³. WHO approved a subunit vaccine for children in 2021 but it has limited efficacy and risk of severe  side effects⁴. Considering these aspects, the use of monoclonal antibodies may be a practical step toward decreasing the number of malaria cases. The trial demonstrated that using antibodies in adults who had not had malaria or received a vaccine previously was associated with substantial passive immunity. The immunity was tested after exposing the participants to controlled human malaria infection. Parasitaemia, as determined by PCR, developed in all 6 participants from the control group, while only two out of 17 participants from the intervention group showed parasitaemia².

Pakistan reports malaria cases throughout the year, with most cases occurring in the summer5. Using antibodies for malaria can help advance protection in countries like Pakistan with seasonal transmission. Although, the economic cost of using this intervention must be considered especially for developing countries.

 

Submission completion date: 10-08-2022

 

Acceptance date: 27-10-2022

 

Disclaimer: None to declare.

 

Conflict of Interest: None to declare.

 

Funding Sources: None to declare.

 

References

 

1.      WHO. World malaria report 2021. Geneva: World Health Organization, 2021.

2.      Wu RL, Idris AH, Berkowitz NM, Happe M , Gaudinski MR , Buettner C, et al. Low-Dose Subcutaneous or Intravenous Monoclonal Antibody to Prevent Malaria. N Engl J Med. 2022; 387:397-407. doi:10.1056/NEJMoa2203067

3.      Khattak AA, Awan UA, Nadeem MF, Yaqoob A, Afzal MS. Chloroquine-resistant Plasmodium falciparum in Pakistan. Lancet Infect Dis. 2021; 21:1632. doi: 10.1016/S1473-3099(21)00700-3.

4.      Nadeem AY, Shehzad A, Islam SU, Al-Suhaimi EA, Lee YS. Mosquirix™ RTS, S/AS01 Vaccine Development, Immunogenicity, and Efficacy. Vaccines (Basel). 2022; 10: 713. doi:10.3390/vaccines10050713

5.      Arain FM, Memon AM, Jamal R, Raheem A, Beg MA Prevalence of Malaria reported during Summer and Winter at a Tertiary Care Hospital in Karachi, Pakistan. J Pak Med Assoc. 2019; 69:1721-4. doi:10.5455/jpma.7805.