Introduction
Infectious illnesses in the tropical disease category are more common in tropical and subtropical regions. Hot and humid weather is typical of these areas, making it hospitable for developing and disseminating a wide range of infectious agents. In addition, inadequate healthcare systems, poor sanitation, and a lack of access to clean water significantly contribute to the persistence and spread of tropical diseases, which disproportionately afflict low-income people in developing nations. The destructive impact of tropical illnesses on public health, economic growth, and general well-being in affected regions makes advancing research on these diseases crucial.
To fight tropical disease, the development of a drug that can effectively treat it is essential. It can be defined as a substance that modifies physiological activities, delivering diagnostic, therapeutic, or preventative advantages when provided at proper levels. Research into tropical pharmacology and toxicology must continue to identify and understand the use of appropriate therapeutic measures for dealing with tropical diseases such as malaria, dengue fever, cholera, leishmaniasis, and schistosomiasis.
Tropical Diseases and Their Treatments
Malaria
The bite of an infected Anopheles mosquito can spread malaria, a potentially fatal illness caused by the parasite Plasmodium. Malaria symptoms can range from mild to severe and from one Plasmodium species to another. High fever, chills, headache, muscular pains, nausea, vomiting, and exhaustion are some of the symptoms that may develop 10 to 15 days after a mosquito bite (Iqbal et al., 2022). Complications include anemia, respiratory distress, renal failure, and even coma; death is possible in the worst situations. Therefore, timely diagnosis and treatment of malaria are essential for avoiding complications and slowing the spread of the disease.
As drug-resistant malaria strains have become more common, advances in treatment have been made. Chloroquine and artemisinin-based combination treatments (ACTs) are two of the most popular medications to combat malaria (Pernaute-Lau et al., 2022). Chloroquine is a well-known antimalarial medication effective against Plasmodium vivax and P. ovale in their blood-stage forms (Pernaute-Lau et al., 2022).
Nevertheless, it is no longer effective against P. falciparum in most of the world due to widespread resistance. Chloroquine’s dose and administration are affected by variables, including the patient’s age, weight, and the strain of malaria they are fighting. The current gold standard for treating uncomplicated P. falciparum malaria is ACTs, which combine an artemisinin derivative with another antimalarial medication. These treatments go to work quickly and effectively, and they seldom cause resistance. Table 1 shows Chloroquine phosphate dose information. The conversion factor between chloroquine phosphate and chloroquine base is 500 mg phosphate to 300 mg base and 1000 mg phosphate to 600 mg base.
Table 1: Dosage and Administration of Chloroquine for Malaria.
Malaria continues to be a serious worldwide health concern, especially in sub-Saharan Africa and South Asia, despite the numerous treatment efforts adopted thus far. About half the global population is in danger of contracting malaria, with the World Health Organization reporting 247 million cases and 619,000 deaths in 2021 alone (UN News, 2022). Malaria is more common in children less than five and pregnant women. The impact of malaria must be lessened and ultimately eradicated. Thus, research into new antimalarial medications, attempts to enhance existing therapies, and the deployment of effective preventive and control measures must continue.
Dengue Fever
Dengue fever is a mosquito-borne viral infection caused by the dengue virus, which is transmitted to humans by the bite of infected Aedes mosquitoes. Dengue fever symptoms might be either minor or severe (Trivedi & Chakravarty, 2022). Early disease symptoms include high fever, severe headache, joint and muscular pain, nausea, vomiting, and a rash (Trivedi & Chakravarty, 2022). Little red dots that may combine to create bigger patches define the rash, which normally emerges within three to four days following the beginning of the fever. Dengue fever, if left untreated, can develop into dengue hemorrhagic fever, a potentially fatal condition characterized by profuse bleeding, severe abdominal pain, prolonged vomiting, and circulatory failure.
Supportive care, including medication and rest, is the core of dengue fever treatments because there is no particular antiviral treatment. In addition, dengue fever treatment relies heavily on a fluid replacement since vomiting and high fever can lead to dehydration (Pandey, 2020). Depending on the severity of the dehydration, intravenous fluids or oral rehydration treatments may be given (Pandey, 2020). Supportive treatment for those with dengue fever also includes managing their discomfort. Nonsteroidal anti-inflammatory medicines (NSAIDs) like ibuprofen and aspirin should be avoided owing to the risk of exacerbating bleeding issues. In contrast, acetaminophen is generally prescribed to lower fever and alleviate discomfort.
High fever, headache, joint and muscular discomfort, and a distinctive rash are typical symptoms of dengue fever. Dengue fever treatment focuses mostly on supportive care, such as fluid replenishment and pain control, to ease symptoms and prevent complications. Better patient outcomes and lower dengue fever-related mortality and morbidity can be achieved by increasing knowledge of the symptoms and providing appropriate supportive treatment.
Cholera
Cholera, caused by the bacterium Vibrio cholerae, is a contagious bacterial illness. It causes severe dehydration because of the fast and excessive loss of bodily fluids through the digestive tract, which is the primary target of the disease. Therefore, cholera is primarily spread when someone eats or drinks anything tainted. Symptoms of cholera include the quick onset of such watery diarrhea that it is sometimes compared to “rice-water stools,” as well as nausea, vomiting, and muscular cramps (Karambizi, 2020). When patients lose a lot of fluid, they can go into shock, which causes their heart rate and blood pressure to drop dangerously low.
Due to the fast loss of fluids, cholera treatment focuses on rehydration and electrolyte replenishment. Mild to moderate instances are often treated with oral rehydration salts (ORS), but severe cases require intravenous fluids (Mohanty et al., 2021). To lessen the intensity and length of the condition, antibiotics, including doxycycline, azithromycin, and ciprofloxacin, can be administered in conjunction with rehydration treatment (Mohanty et al., 2021).
Antibiotics that inhibit Vibrio cholerae’s growth effectively stop the disease. Nonetheless, therapy must commence quickly to avoid problems and deaths. In addition, reducing the spread of cholera requires preventative measures such as access to clean water, good sanitation, and hygiene habits.
Leishmaniasis
Protozoan parasites of the genus Leishmania cause leishmaniasis, a tropical illness transmitted to humans by the bite of infected female sandflies. Each subtype of this illness, such as cutaneous, mucocutaneous, or visceral leishmaniasis, has its symptoms. The most prevalent form of leishmaniasis, known as cutaneous leishmaniasis, manifests as blisters on the skin that, in time, may develop into painless ulcers with elevated edges (Severino et al., 2022).
Leishmaniasis affects the skin, mucosal tissues, and cartilage and can lead to ugly sores in the mouth and nose. The most serious type of leishmaniasis is called visceral leishmaniasis or kala-azar and affects the internal organs such as the spleen, liver, and bone marrow (Severino et al., 2022). Symptoms might include fever, lack of appetite, anemia, and enlarged organs, including the liver and spleen.
Leishmaniasis is treated differently depending on the patient’s symptoms, the severity of the condition, and where it was contracted. Leishmaniasis is often treated first with pentavalent antimonials (SbV), including sodium stibogluconate and meglumine antimoniate (Pinart et al., 2020). These drugs need 20-28 days of daily intravenous or intramuscular injections (Pinart et al., 2020).
Nevertheless, in some areas, especially the Indian subcontinent, the usage of pentavalent antimonials has been linked to severe toxicity and the development of drug resistance (Gupta et al., 2023). In circumstances where resistance to pentavalent antimonials has been established or where patients are intolerant of antimonial therapy, amphotericin B is an alternative medication for leishmaniasis (Pinart et al., 2020). The medicine comes in both oral and liposomal forms. It is a member of the polyene antibiotic family.
The standard treatment for visceral leishmaniasis is intravenous administration of conventional amphotericin B. However, the liposomal version, which carries a decreased risk of adverse effects, is favored. Close monitoring and follow-up care are vital to attaining a positive outcome, as the choice of therapy, dose, and duration relies on the patient’s specific situation and the type of disease.
Schistosomiasis
Schistosomiasis, or bilharzia, is a parasitic disease caused by blood flukes from the genus Schistosoma. Humans become infected after touching larval parasites in freshwater, which burrow under the skin and develop into adult worms. Adult worms dwell in blood vessels and lay eggs that can harm other organs by triggering inflammation and even organ failure. Schistosomiasis symptoms can range from mild to severe, depending on the species of Schistosoma and the infection’s progression.
Chronic schistosomiasis can cause stomach discomfort, diarrhea, blood in the stool or urine, and liver or spleen enlargement. In contrast, acute schistosomiasis, known as Katayama fever, may cause fever, chills, muscular pains, and exhaustion (Al Amin & Wadhwa, 2020). In addition, schistosomiasis can lead to serious side effects such as liver fibrosis, portal hypertension, and bladder cancer in its most extreme forms.
Praziquantel is the preferred therapy for treating schistosomiasis since it is an anthelmintic medication that is both effective and safe. Praziquantel kills worms by producing rapid muscular contraction, which causes paralysis and separation from blood vessels and makes them easy targets for the host’s immune system (Timson, 2020). The praziquantel dose is adjusted based on the patient’s weight and the Schistosoma species causing the illness. Supportive care is typically provided alongside praziquantel treatment to alleviate symptoms and reduce the risk of complications. Schistosomiasis is fought using a combination of pharmaceuticals and public health measures to reduce the disease’s prevalence.
Conclusion
In conclusion, knowledge of tropical illnesses is crucial since they pose a serious risk to world health, especially in underdeveloped regions with inadequate medical facilities and personnel. Given the global prevalence of these conditions, the search for viable therapeutics should remain a top priority in drug research both now and in the future. Improved public health education, vector control, and the creation of effective vaccinations are just a few examples of preventative and control efforts that must be undertaken to lessen the occurrence and impact of these illnesses. Researchers, medical experts, and politicians working together can make significant strides in the battle against tropical illnesses and eventually enhance the quality of life for people afflicted.
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