Bioactive compounds as therapeutic proposals against Plasmodium falciparum: A systematic review

Abstract

Malaria, transmitted by infected female mosquitoes, is caused by protozoan parasites, of which Plasmodium falciparum is the main species causing clinical manifestations. Malaria affects 87 tropical countries and, according to the World Malaria Report 2021, an estimated 241 million cases of malaria in 2020 led to about 627,000 deaths. Pharmacological treatment is essential to control the morbidity and mortality associated with the clinical manifestation of this disease. However, the excessive deployment of antimalarial drugs has led to drug resistance, which poses a serious threat to public health. Given the reduced discovery and development of new antimalarial drugs the use of specialised plant metabolites is considered a promising strategy to propose new mechanisms and investigate their efficacy in animal and human models. This is a systematic review of several studies, carried out according to the guidelines of the PRISMA statement. The studies were identified in various databases, including EBSCO, Pubmed (MEDLINE), Science Direct, SAGE, Scopus, and Web of Sciences. Eligible studies had to demonstrate the compounds’ ability to inhibit P. falciparum strains through biological activity. Four independent reviewers extracted information from the included studies, and two independent reviewers assessed the risk of bias using the CASP systematic review checklist. A total of 2541 studies were initially identified, of which 147 were selected for full-text reading. Of these, studies met the eligibility criteria. The eligible studies were conducted between 2018 and 2024 and came from different countries. The quality of the studies was assessed using the CASP tool. This review provides evidence that plant metabolites could be a valuable resource for the development of new antimalarial drugs. This is supported by extraction and identification techniques and by the evaluation of their mechanisms of action.