Malaria drug resistant: current situation with reference to Saudi Arabia (review).

Malaria is a chronic disease caused by parasitic protozoa of plasmodia species. Four plasmodium species are causing malaria to human (P. vivax P. ovale, P. malariae and P. falciparum). Malaria classifies as one of the most serious diseases in tropical and subtropical countries and p. falciparum represents the major cause of death by malaria species. Approximately 40% of the world population resides in areas of active malaria transmission. Treatment and prophylaxis measures are important to reduce morbidity and mortality rate of infection. In last two decades, a significant number of malaria drug resistance cases (mainly P. falciparum) were reported in endemic areas against choroquine components. Parasite showed enormous amount of antigenic variation under immune pressure leading to emergence of vaccine resistant strains. Similarly, under drug pressure it allows mutations to settle in the target genes. It is becoming more and clearer that with the continuous exposure to a drug, the parasite accumulates more and more number of mutations in these genes. Artemisinin is the only available drug that is globally effective. This review concentrates on the current situation of malaria drug resistance including epidemiological distribution, the mechanism of how the malaria resists certain drugs and the role of recent advances facilities in molecular biology to evaluate the impact on drug resistance of new drug-based strategies in Saudi Arabia.