Peran Kina dalam terapi malaria
Kajian mekanisme, risiko, dan kedudukannya kini
Keywords:
Malaria, plasmodium, quinines, antimalarial, therapyAbstract
Malaria is an infectious disease caused by Plasmodium parasites transmitted through the bite of female Anopheles mosquitoes. Four major species infect humans: P. falciparum, P. vivax, P. malariae, and P. ovale, with P. falciparum being the most dangerous due to its potential to cause severe complications and death. Quinine, an alkaloid derived from the bark of the Cinchona tree, was the first antimalarial drug proven effective against all Plasmodium species. Its primary mechanism involves inhibiting the detoxification of heme into hemozoin within the parasite’s food vacuole, leading to toxic heme accumulation and parasite death. Despite its effectiveness, quinine use is often associated with side effects known as cinchonism, characterized by tinnitus, visual disturbances, nausea, vomiting, and in severe cases, hypoglycemia, arrhythmias, and blackwater fever. Currently, quinine has largely been replaced by artemisinin-based combination therapy (ACT), which offers greater efficacy and improved patient compliance. Nevertheless, quinine remains relevant as an alternative treatment, particularly in severe malaria when intravenous artesunate is unavailable or during the first trimester of pregnancy. Thus, quinine continues to serve as an important reserve drug in regions with limited access to modern therapies.
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