Malaria, how the world has been able to control the disease

Malaria is a serious disease caused by plasmodium parasites. The parasites are spread to people through the bites of infected female Anopheles mosquitoes, called “malaria vectors”.  Malaria sometimes proves to be a dangerous and fatal disease.

Malaria has prehistoric origin as a zoonotic disease in the primates of Africa through to the 21st century. Malaria infected every continent except Antarctica. The World Health Organization estimates that in 2018, 228 cases million clinical cases of malaria occurred and 405,000 people died. As malaria causes so much illness and death, the disease is a great drain on many national economies. The disease is known to maintain a vicious cycle of disease and poverty.

According to WHO, Malaria is an acute febrile illness. Symptoms in a non-immune individual appear approximately 10-15 days after being bitten by an infective mosquito. Symptoms of malaria include fever, headache, chills. They are often difficult to recognize as symptoms of malaria. If not treated within 24 hours, P. falciparum malaria can progress to severe illness, often leading to death. People get malaria after being bitten by female Anopheles mosquitoes. Only Anopheles mosquitoes can transmit malaria after being infected through a previous blood meal taken from an infected person. The parasite is found in the red blood cells of an infected person. It can be transmitted through blood transfusion, organ transplant, or the shared use of needles or syringes contaminated with blood. It can also be transmitted from an infected mother to an unborn child. However, malaria is not transmitted from one person to another. One cannot get malaria through casual contact with a person.

Vector control is the only way to prevent malaria from spreading. There are two forms of vector control – insecticide-treated mosquito nets and indoor residual spraying. They are effective in a wide range of circumstances. Insecticide-treated mosquito nets, when used while sleeping, can reduce contact between mosquitoes and humans by providing both a physical barrier and an insecticidal effect. From the killing of mosquitoes on a large scale where there is high access and usage of such nets within a community can result in population-wide protection. Indoor residual spraying (IRS) with insecticides is another powerful way to rapidly reduce malaria transmission. Spraying the inside of housing structures with an insecticide, typically once or twice per year is recommended. To confer significant community protection, IRS should be implemented at a high level of coverage.

There are a number of anti-malaria drugs available for protection and care. Chloroquine, artemisinins, insecticide called DDT (DichloroDiphenylTrichloroethane), pyrethrum are all anti-malarial drugs. Use of chemoprophylaxis, intermittent preventive treatment with sulfadoxine-pyrimethamine are also some of the recommended anti-malarial drugs used. Since 2012, WHO has recommended seasonal malaria chemoprevention as an additional malaria prevention strategy. Early diagnosis and treatment of malaria reduces disease and prevents deaths. It also contributes to reducing malaria transmission. The best available treatment, particularly for P. falciparum malaria, is artemisinin-based combination therapy (ACT). RTS,S/AS01 (RTS,S) is the first and, to date, the only vaccine to show that it can significantly reduce malaria, and life-threatening severe malaria.

The permanent reduction to zero of the worldwide incidence of malaria infection caused by human malaria parasites as a result of deliberate activities is known as malaria elimination. Continued measures are required to prevent re-establishment of transmission.

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