This year’s theme for World Malaria Day is End Malaria for good!
Spot light is on prevention – A critical strategy for reducing the toll of the disease that kills more than 400,000 annually since year 2000.
Malaria is caused by parasites transmitted to people through the bites of infected female Anopheles mosquitoes. There are 5 species of plasmodium that can cause malaria: Plasmodium falciparum, Plasmodium vivax, Plasmodium malariae, Plasmodium ovale Plasmodium knowlesi (which infects animals).P. falciparum (the most prevalent in Africa) pose the greatest threat while P. vivax is the dominant parasite outside Sub-Saharan Africa. Sub- Saharan Africa continues to carry a disproportionately high share of the global Malaria burden.
WHO IS AT RISK
As at 2015, nearly half of the world’s population was at risk of Malaria. Most cases and deaths occurring in sub Saharan Africa, However South East, Asia, Latin America and the Middle East are also at risk.
Some population groups are at higher risk of contracting malaria than others e .g
Infants & Children under 5 years of Age (More than 70% of all malaria deaths occur in the group).
People living with HIV/AIDS
Non –immune migrants
There are more than 400 difference species of Anopheles mosquito about 30 are important malaria vectors, all of which bite between dusk and dawn. Transmission is more intense in:
(1) Places where the mosquito lifespan is longer (such that the parasite has time to complete its development inside the mosquito) and
(2) Where it prefers to bite humans rather than animals. These are the 2 major reasons why nearly 90% of the world’s malaria cases are in Africa. Transmission also depends on climatic conditions that may affect the survival of mosquitoes such as rainfall e.t.c
1. Vector control is the main stay of Malaria prevention and transmission,WHO recommends :1 Insecticide treated mosquito nets .2.Indoor residual spraying
Partial immunity is developed over years of exposure though it doesn’t provide complete protection it reduces the risk that the infection becomes a severe disease.
2. Chemo prophylaxis can be used for travellers (to suppress the blood stage of the infection thereby preventing the disease.
For pregnant women WHO recommends Intermittent Prevent treatment with Sulphadoxine Pyrimethamine at each scheduled visit after 1st trimester.
For infants in these areas WHO recommend 3 doses of Sulphadoxine –Pyrimethamine delivered alongside routine vaccines.
DIAGNOSIS AND TREATMENT
Early diagnosis & treatment of malaria reduces disease and prevents deaths. It also contributes to reducing malaria transmission. WHO recommends that all cases of suspected malaria be confirmed using parasite –based diagnostic testing (either microscopy or rapid diagnostic test) before administering treatment .Treatment solely on the basis of symptoms should only be considered when a parasitological diagnosis is possible. Artemisinin-containing therapy is the recommended treatment for Malaria.
ANTIMALARIAL DRUGS & INSECTICIDE RESISTANCE
Resistance to antimalarial medicines is a recurring problem.Resistance of p.Falciparum to previous generations of medicines such as chloroquine & Sulfadoxine –Pyrimethamine (SP) became widespread undermining malaria control efforts.
In recent years parasite resistance to artemisinin has been detected in 5 countries .Studies have confirmed that Artemisinin resistance has emerged independently in many areas of this sub-region.
In recent years mosquito resistance to Pyrethroids (which are the class of insecticides currently recommended for insecticide treated nets , ITN)
There are currently no licensed vaccines against malaria, though work is currently in the conclusive stage for RTS,S/ASOI vaccine against malaria.
Excerpt from WHO FACT SHEET DEC 2016.
From the excerpts above, it is evident that kicking out malaria is a job to be done by everyone. Let us all join hands in placing emphasis on prevention and provide quality health care delivery whenever the disease presents.