Stage-specific actions of antimalarial drugs

Key to the theory behind antimalarial treatment is understanding the stage-specific actions of drugs and on a related note their mechanisms of action. The life cycle of malaria is complex and most drugs intervene on limited portions of it. I came across this beautiful figure in a 1962 article from the Bulletin of the World Health Organization (open access!) by Dr Bruce-Chwatt, one of the foremost malariologists of all time and the author of that invaluable malaria bible Essential Malariology. Some of the drugs are outdated but the clear categorization and definitions, separating causal prophylactics from sporonticidal drugs for example which many people confuse, are brilliant. Why does prophylaxis with atovaquone-proguanil continue for 1 week post-return from endemic areas while most other drugs must be continued for 4 weeks?Understanding this diagram tells you why.

 

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