**Abstract**

Malaria is a potentially fatal blood disease spread by mosquitos. Malaria is preventable, but it is more prevalent in developing countries where prevention is difficult and prophylaxis is often inaccessible. Malaria remains one of the world's most serious public health problems, according to the World Health Organisation (WHO). The development of resistance is a current problem that poses a danger to the environment. Resistance is a current problem that could jeopardise the use of well-established and cost-effective antimalarials. The World Health Organisation recommends an artemisinin-based drug combination (ACT) to avoid or postpone the development of resistance. This book's chapter discusses current medicines as well as potential and rational possibilities for finding new drugs to treat malady. There were also WHO recommendations for both complicated and noncomplicated malaria. Other preventive measures such as ITN and IPT are listed in the manuscript in addition to routine care. While a brief overview of the vaccine tested so far has been included, there is currently no vaccine available to treat malaria.

**Keywords:** Malaria, *Plasmodium falciparum*, artemisinin, drug repurposing, drug resistant malaria

### **1. Introduction**

Malaria is a life-threatening disease spread by mosquito bites from infected female Anopheles mosquitos ("malaria vectors"). The Plasmodium parasite is borne by infected mosquitos. When an individual is bitten by this mosquito, the parasite is released into the bloodstream. Malaria is caused by a parasitic protozoan of the genus Plasmodium. *Plasmodium vivax*, *Plasmodium ovale*, *Plasmodium malariae,* and *Plasmodium falciparum* are the four types of malaria parasites that can infect humans. *Plasmodium falciparum* and *Plasmodium vivax* are the two most deadly species, responsible for more than 95 percent of all malaria cases worldwide. Each year, approximately 125 million pregnant women are at risk of infection; maternal malaria is linked to up to 200,000 reported child deaths in Sub-Saharan Africa. [1, 2] Maternal malaria is often linked to a number of negative outcomes for the mother, the foetus, and the infant.

The sporozoite form of the protozoan is preserved in the salivary glands of the mosquito. When a person is bitten by an infected female Anopheles mosquito, sporozoites are injected into the bloodstream and easily move into the human liver. The sporozoites replicate asexually in the liver cells for the next 7 to 10 days, causing no symptoms. The parasites are released in the form of merozoites from the liver cells and settle in the capillaries of the lungs. Merozoites are released from lung capillaries in the blood phase (also known as pathologic blood stages) of their growth, invading red blood cells (erythrocytes) and multiplying until the cells burst. This cycle continues forever, invading younger red blood cells. These infections in the blood can last for months. Some infected blood cells break the asexual multiplication cycle. Merozoites evolve into sexual forms of the parasite called gametocytes (precursors of male and female gametes) in these cells, which then circulate in the bloodstream. Malaria parasites will now abandon their human hosts and complete their life cycle in an insect vector. When a fertilised mosquito bites an infected individual, the gametocytes in the blood are swallowed by the mosquito, and the gametocytes mature in the mosquito gut. An ookinete is a fertilised, motile zygote produced when male and female gametocytes fuse. Ookinetes grow into new sporozoites, which migrate to the salivary glands of the bug, ready to infect a new host and restart the human infection cycle (**Figure 1**) [3].

Only certain species of mosquitoes of the Anopheles genus—and only females of those species—can transmit malaria. Chills, high fever, profuse sweating, headache, muscle pains, malaise, diarrhoea, and vomiting are all common symptoms of malaria. Malaria, on the other hand, is marked by occasional paroxysmal febrile episodes (i.e., a sudden recurrence or intensification of fever), and untreated infection results in spleen enlargement. *P. falciparum* can affect the lungs, liver, and kidneys, as well as cause extreme anaemia and coma in cerebral malaria, which sometimes leads to death. P. malariae infection can cause kidney damage, which can lead to nephrotic syndrome, which can be fatal. Malaria infections are highly debilitating and can render a person vulnerable to other diseases [4].
