1*Nityanand Upadhyay
ABSTRACT
Apart from sub-Saharan Africa, P. vivax is the most common human malaria parasite and can be found throughout tropical and subtropical climates. The present review was based on the drug resistance on Plasmodium vivax; pathophysiology and complications of malaria for which an extensive literature survey was done using PubMed, Scopus and Google Scholar. Over 200 million clinical instances of P. vivax infection occur each year, and an estimated 3.2 billion people worldwide are at risk of contracting the virus. Symptoms of malaria typically include headache, nausea, vomiting, chills, shivering, and a recurring fever. P. vivax infections had long been thought to be comparatively benign, resulting in modest clinical signs, and to not sequester in the deep capillaries of organs. The serious diseases and fatalities linked to P. vivax infections have raised the potential of parasite sequestration in organs, according to recent research. First documented in 1989 in Papua New Guinea, resistance to chloroquine (CQ) in P. vivax has now spread to the majority of endemic regions in Southeast Asia. The northeastern coast of Indonesian Papua was found to have the highest prevalence of CQ-resistant P. vivax. Gene mutations encoding vital enzymes or transporters seem to be the primary cause of anti-malarial medication resistance. Chloroquine resistance indicators in P. vivax have been discovered as the putative transporter protein (Pvcrt-o) and P. vivax multidrug resistance (Pvmdr), which are orthologous to the Pfmdr1 and Pfcrt genes. The placenta becomes inflamed when cytokines including IL-1, IFN-γ, TNF-α, and IL-2 are produced. In conclusion, various complications were reported including parasite sequestration and severe malaria, severe malarial anaemia, acute respiratory distress syndrome and pregnancy-associated malaria. Additionally, P. vivax causes trophoblast membrane malfunction, changes to the intervillous and perivillous gaps, and impaired oxygen and nutrition delivery to the growing fetus.
Keywords: Plasmodium vivax, drug resistance, pathogenesis, chloroquine, malarial parasite