Malaria is preventable and curable, and increased efforts are dramatically reducing the malaria burden in many places. Between 2010 and 2015, malaria incidence among populations at risk (the rate of new cases) fell by 21% globally. In that same period, malaria mortality rates among populations at risk fell by 29% globally among all age groups, and by 35% among children under five years of age (WHO, 2016). Sub-Saharan Africa carries a disproportionately high share of the global malaria burden. In 2015, the region was home to 90% of malaria cases and 92% of malaria deaths (Baird and Rieckmann, 2003).
Plasmodium Falciparum Cases
The four Plasmodium spp. that causes malaria in human beings are : Plasmodium falciparum, P. vivax, P. ovale, and P. malariae. P. falciparum is the most important because it accounts for the majority of infections and causes the most severe symptoms. Humans occasionally become infected with Plasmodium species that normally infect animals, such as P. knowlesi. As yet, there are no reports of human–mosquito–human transmission of such “zoonotic” forms of malaria. Malaria is an acute febrile illness with incubation period of 7 days or longer. Thus, a febrile illness developing less than 1 week after the first possible exposure is not malaria.
The most severe form is caused by P. falciparum; variable clinical features include fever, chills, headache, muscular aching and weakness, vomiting, cough, diarrhoea and abdominal pain. Other symptoms related to organ failure may supervene, such as acute renal failure, pulmonary oedema, generalized convulsions, circulatory collapse, followed by coma and death. The initial symptoms, which may be mild, may not be easy to recognize as being due to malaria (Durand et al., 2008).
Possibility of Falciparum Malaria
It is important that the possibility of falciparum malaria is considered in all cases of unexplained fever starting at any time between 7 days after the first possible exposure to malaria and 3 months (or rarely later) after the last possible exposure. Any individual who experiences a fever in this interval should immediately seek diagnosis and effective treatment, and inform medical personnel of the possible exposure to malaria infection. Falciparum malaria may be fatal if treatment is delayed beyond 24 hours after the onset of clinical symptoms (WHO, 2015).
Antimalarials are used in three different ways: prophylaxis, treatment of falciparum malaria, and treatment of non-falciparum malaria. Prophylactic antimalarials are used almost exclusively by travelers from developed countries who are visiting malaria-endemic countries. Treatment protocols for falciparum malaria vary, depending on the severity of the disease; fast-acting, parenteral drugs are best for severe, life threatening disease. In addition, treatment protocols for falciparum malaria vary geographically and depend on the resistance profiles for strains in particular regions. Non-falciparum malarias, in contrast, rarely are drug resistant.
Although P. vivax and P. ovale have dormant liver stages that may cause relapses months to years after an infection is cleared. Thus needs to be treated with an additional agent that can clear this stage. Commonly used antimalarials are from various classes of compounds, and they include: the Quinolines (chloroquine, quinine, mefloquine, amodiaquine, primaquine), the Antifolates (pyrimethamine, proguanil and sulfadoxine),the Artemisinin derivatives (artemisinin, artesunate, artemether, arteether) and Hydroxynaphthaquinones (atovaquine) (Saifi et al., 2013)
Cameroun and Nigeria
Lecaniodiscus cupanioides is found in some part of Asia and west Africa such as Ghana, Cameroun and Nigeria. It is an elegant tree with a low-branching, spreading crown; it can grow up to 12metres, sometimes more, tall. Lecaniodiscus cupanioides (Sapindaceae) is widely used in Nigerian folk medicine for the treatment of inflammatory conditions, hepatomegaly and bacterial infections (Mikhail et al., 2013).
Research investigated the antioxidant and antibacterial activity of the methanolic extract of the leaves to justify its use in traditional medicine. The plant is ethnomedically reputed to be useful in the treatment of wounds and sores, abdominal swelling caused by liver abscess, fevers, measles, hepatomegaly and burns, among others. hepatomegaly and burns, among others (Yemitan et al., 2005). Research attributed the antioxidant potential of L. cupanioides leaf extract to its strong proton donating ability and justified its use for the treatment of bacterial infections in ethnomedicine (Sen et al., 2002).
The methanol leaf extract was reported by Sofidiya et al., (2008) to possess strong antioxidant and antibacterial activity.Plants have been the basic source of sophiscated traditional medicine systems for thousands of years and were instrumental to early pharmaceutical drug discovery and industry (Elujoba et al., 2005).
History of Malaria
The history of malaria stretches from its prehistoric origin as a zoonotic disease in the primates of Africa through to the 21st century. A widespread and potentially lethal human infectious disease, at its peak malaria infested every continent, except Antarctica (Carter R, Mendis KN, 2002). Its prevention and treatment have been targeted in science and medicine for hundreds of years.