Based on earlier studies, a significant trend for higher frequencies of the resistance markers with increasing CQ concentrations was observed in Pf malaria i.e. prior use of CQ in enrolled patients (Ehrhardt et al. 2005). Pre-treatment of blood CQ concentration has an inverse relation with degree of Pf resistance to CQ (Quashie et al. 2005).
High pretreatment blood CQ concentration assists in eliminating CQ resistant strains of the parasites during drug treatment (Quashie et al. 2005). However, the scope of examining the impact of pre-hospital CQ and SDX on the resolution of malaria following treatment with antimalarials such as artemisinin based combination therapy, which is the first line of drug for the management of Pf malaria, still remains open. Keeping the above points in mind the following objectives were set for my research work:
‘ To monitor the residual antimalarial levels in malaria patients in high endemic districts in the country.
‘ To correlate the residual antimalarial levels with molecular marker of drug resistance for Chloroquine, Sulphadoxine and Pyrimethamine.
‘ To establish links between presence of residual antimalarials and therapeutic outcome, if any.

Chapter II
Literature review:
In this chapter deal in the aspect the existing knowledge about malarial life cycles, vectors, diagnosis s, treatment , distribution, mode of action antimalarials, antimalarial drug resistance and factor affecting to drug resistance with special emphasis on irrational use of antimalarial drug and its effect in the community have been review.
Review literature
Malaria is a life-threatening disease and is widespread in the tropical and subtropical regions mainly around the equator. Malaria is a protozoan disease and transmitted through infected female anopheles mosquitoes. Malaria parasite is require two hosts to complete their life cycle; one is definitive host (Sexual cycle) in Anopheles mosquito and second intermediate host (Asexual cycle) in human. Haploid parasite adopts three different cellular strategies in the distinct phases of the complex life cycle. In the human, schizogony (Asexual reproduction) occurs and this schizogony is found as two types, one erythrocytic schizogony ‘ found in erythrocytes and second exo-erythrocytic schizogony ‘ found in other tissues (Liver).
There are 430 species of Anopheles mosquitoes, and out of these, 58 species are identifying in India. Seven of these have been known as the main malaria vectors in India, namely An. culicifacies, An. dirus, An. fluviatilis, An. minimus, An. Sundaicus, An. Stephensi and An. Philippinesis..
Epidemiology of malaria
Globally, an estimated 3.4 billion people are at risk of malaria. WHO estimates that 207 million cases of malaria occurred globally in 2012 and 627 000 deaths. Most cases deaths reported in Africa and under 5 years children were in most deaths (77%) (WHO malaria report 2013). In South East Asia (SEA) con