• Artemisia annua and Artemisia afra tea infusions vs. artesunate-amodiaquine (ASAQ) in treating Plasmodium falciparum malaria in a large scale, double blind, randomized clinical tria 

Artemisinin content of A. afra was negligible, but therapeutic responses of patients were similar to A. annua-treated patients; trophozoites cleared after 24 h, but took up to 14 d to clear in ASAQ-treated patients. D28 cure rates defined as absence of parasitemia were for pediatrics 82, 91, and 50% for A. afra, A. annua and ASAQ; while for adults cure rates were 91, 100, and 30%, respectively. Fever clearance took 48 h for ASAQ, but 24 h for Artemisia. From D14–28 no Artemisia-treated patients had microscopically detectable gametocytes, while 10 ASAQ-treated patients remained gametocyte carriers at D28. More females than males were gametocyte carriers in the ASAQ arm but were unaffected in the Artemisia arms. Hemoglobin remained constant at 11 g/dl for A. afra after D1, while for A. annua and ASAQ it decreased to 9–9.5 g/dl. Only 5.0% of Artemisia-treated patients reported adverse effects, vs. 42.8% for ASAQ.

Conclusion: A. annua and A. afra infusions are polytherapies with better outcomes than ASAQ against malaria. In contrast to ASAQ, both Artemisias appeared to break the cycle of malaria by eliminating gametocytes. This study merits further investigation for possible inclusion of Artemisia tea infusions as an alternative for fighting and eradicating malaria.

Munyangi J, Cornet-Vernet L, Idumbo M, et al. Artemisia annua and Artemisia afra tea infusions vs. artesunate-amodiaquine (ASAQ) in treating Plasmodium falciparum malaria in a large scale, double blind, randomized clinical trial [retracted in: Phytomedicine. 2020 Nov;78:153304]. Phytomedicine. 2019;57:49-56. doi:10.1016/j.phymed.2018.12.002
 

• In vitro reduction of Plasmodium falciparum gametocytes: Artemisia spp. tea infusions vs. artemisinin 

Both A. annua and A. afra tea infusions reduced gametocytemia in vitro, and the effect was mainly artemisinin dependent. Expression levels of both marker genes were reduced and also occurred with the effect mainly attributed to artemisinin content of four tested Artemisia cultivars. Tea infusions of both species also inhibited asexual parasitemia and although mainly artemisinin dependent, there was a weak antiparasitic effect from artemisinin-deficient A. afra

These results showed that A. annua and to a lesser extent, A. afra, inhibited parasitemia and gametocytemia in vitro.tis.

Snider, D., & Weathers, P. J. (2021). In vitro reduction of Plasmodium falciparum gametocytes: Artemisia spp. tea infusions vs. artemisinin. Journal of Ethnopharmacology, 268, 113638.

• Artemisia annua (Sweet Annie), Other Artemisia Species, Artemisinin, Artemisinin Derivatives, and Malaria

This paper reviews the use of whole-plant Artemisia annua (sweet Annie) as it pertains to malaria including history, chemistry, clinical efficacy, pharmacokinetics, dosing, safety, and resistance. Artemisinin, the sesquiterpene lactone found in the plant, and various semi-synthetic variants of it used as critical drugs around the world for malaria are discussed in comparison to the whole plant. The multifaceted potential of A. annua against malaria including as a mosquito larvicide and to prevent transmission is discussed. The critical importance of combination therapy with this herb (be it with well-studied synthetic drugs or as-yet poorly studied natural products with activity against malaria, notably curcumin) is reviewed. The relevance of non-artemisinin chemicals in A. annua is highlighted. The pharmacokinetic and pharmacodynamic limitations of A. annua and artemisinins for prophylaxis against malaria are presented. Other Artemisia species besides A. annua, whether they contain artemisinin or not, are also touched upon in the context of malaria.

Yarnell, E. (2014). Artemisia annua (sweet annie), other artemisia species, artemisinin, artemisinin derivatives, and malaria. Journal of Restorative Medicine, 3(1), 69-84.

• In vitro analyses of Artemisia extracts on Plasmodium falciparum suggest a complex antimalarial effect
• In vitro reduction of Plasmodium falciparum gametocytes by Artemisia spp. tea infusions1  Snider D, Pamela J. Weath, 2020
• Traditional application and modern pharmacological research of Artemisia annua L.  Xinchi Fenga, Shijie Caob, Feng Qiua, Boli Zhang, 2020
• Artemisia annua as a Traditional Herbal Antimalarial, la vie rebelle
• Drug-Resistant Malaria: The Era of ACT

As drug-resistant falciparum malaria has continued to evolve and spread worldwide, artemisinin-based combination therapies (ACT) have become the centerpiece of global malaria control over the past decade. This review discusses how advances in antimalarial drug resistance monitoring and rational use of the array of ACTs now available can maximize the impact of this highly efficacious therapy, even as resistance to artemisinins is emerging in Southeast Asia.e