Environmental Impact Assessment for Sustainable Development in Malaria-Endemic Regions: Addressing the Threat of Drug-Resistant Plasmodium falciparum in Africa

Abstract Malaria is a significant cause of death for children under the age of five years and pregnant mothers. In Africa, Plasmodium falciparum is the primary cause of malaria. According to the World Health Organization, sub-Saharan Africa accounts for over 84% of malaria cases worldwide. This impact leads to an economic burden and high mortality rates of maternal and infant mortality. The pathogenic virulence of Plasmodium falciparum is attributed to specific molecular markers that confer resistance to antimalarial medications. The observed genetic variability in markers, such as the chloroquine resistance transporter genes and dihydrofolate reductase pathway, result from events related to mutations or changes that transpire at one identifiable genetic loci. This resistance significantly reduced therapeutic efficacy in most African countries. This review examined the growth and spread of resistance mechanisms and evaluated potential antimalarial drugs using novel medication combinations. A key focus of this review is the potential to identify and validate new molecular markers in blood samples from infected patients using DNA methylation profiling, microarrays, and DNA and RNA sequencing. The significance of this is that it reveals the trends of the parasite spread and the consideration of combining molecular marker testing with clinical treatments. This knowledge would assist researchers in looking for accurate and real-time markers to evaluate artemisinin combination therapy resistance. The emergence and spread of drug-resistant Plasmodium falciparum pose a challenge to global health. Therefore, sustainable development strategies to address this issue will focus on informed decision-making, baseline assessment of previous information on drug resistance, and future forecasts on the impact of molecular markers in most African countries.