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Lorenz von Seidlein Malaria is a life-threatening disease of public health importance, especially in sub-Saharan Africa. It is estimated that about million cases of malaria occur annually and among these 1 million die annually. Children below five years and pregnant women are the most vulnerable groups. Several malaria control measures have been applied such as environmental improvements, use of insecticide impregnated nets, residual indoor spraying, early case detection and treatment with effective antimalarial drugs.
However, the adaptation of vector and parasite has so far limited the effect of these interventions. The emergence of resistance against drugs and insecticides requires in response a steady stream of new interventions. Up to the beginning of this millennium, most sub-Saharan African countries have been using chloroquine CQ as the first-line antimalarial drug, which had to be replaced with sulphadoxine-pyrimethamine SP after resistant parasites had rendered CQ ineffective.
Currently the first line treatment of malaria consists of combination therapy which includes an artemisinin derivative. The current approach appears robust but history has taught us to be alert and to expect resistance to emerge. There is a pressing need to develop and deploy complimentary strategies.
Adding a protective vaccine to the existing control tools for malaria holds great promise yet no malaria vaccine has ever been licensed despite a large number of attempts.
The complexity of malaria parasites and the ability of the parasite to suppress and evade immune responses are formidable challenges. Fortunately, there are several promising antimalarial vaccine candidates in the development pipeline.