Malaria - What You Need To Know
Updated: May 20, 2019
Quick Facts about Malaria
Yearly, 110 million malaria cases are clinically diagnosed. In year 2017 alone, 219 million cases of malaria were recorded and 435, 000 fatalities recorded in the same year according to WHO.
Malaria is endemic in Nigeria and accounts for up to 25% of the malaria burden in Africa. Children < five years as well as pregnant women are the most vulnerable to malaria.
People with diseases that suppress immune function (such as HIV/AIDS) are easily susceptible to malaria infection. The same goes for immigrants or tourists from non-endemic areas/countries. The elderly population are also highly susceptible.
Sharing unsterilized needles and sharps of a person carrying the plasmodium parasite can result in malaria transmission.
Blood infected with plasmodium when transfused to uninfected patients can also lead to malaria. In the same vein, a pregnant woman can also transmit malaria to her unborn foetus through the placenta leading to restricted foetal growth or death.
Malaria accounts for up to 11% of maternal deaths and up to 30% hospitalization for children < 5 years old.
How Malaria Infects Humans
Humans get infected with malaria when actions of two main factors (parasite and vector) are synergized.
The Parasite- the Plasmodium species are the villains that cause malaria. There are over a 100 species of them however, the commonest ones are P. Falciparum, P. Vivax, P. Ovale, P. Malariae and P. Knowlesi. P. falciparum causes the most severe forms of malaria and it is the commonest specie indicated in malaria infections in Nigeria. P. Knowlesi is known to cause only zoonotic infections.
The Plasmodium parasite cannot infect man by itself. It requires an agent/vector to be able to get into the human blood stream. It gets into the blood stream when a vector (carrying its parasite) bites a human. Once the parasite is ejected into the blood stream, it finds its way into the liver where it goes on to mature and reproduce. Thereafter, it gets released into the blood stream where it wreaks havoc on the red blood cells giving symptoms and signs of malaria.
The Vector- The female Anopheles mosquito is the perfect carrier of the plasmodium parasite. It is the link between the plasmodium parasites and man. The Anopheles mosquito is found worldwide (except in Antarctica). Different species affect different geographic regions across the world.
Anopheles mosquitoes lay their eggs in water, which hatch into larvae, eventually emerging as adult mosquitoes. The female mosquito seeks a blood meal to nurture its eggs and, in the process, picks up Plasmodium parasites from an infected person as it takes a bite.
The survival and population of mosquitoes depend on certain factors including climatic conditions such as rainfall patterns, temperature and humidity. In many places, transmission is seasonal, with the peak during and just after the rainy season.
Knowledge of the behavioral patterns and lifecycle of the female anopheles mosquito informs us on how best to prevent the proliferation of malaria parasites and malaria all together.
Symptoms of Malaria
A person infected with malaria will have a couple of symptoms and signs including fever, chills and rigor, sweating, headache, abdominal pain, joint pains, fatigue, diarrhea, loss of appetite, nausea and vomiting. These symptoms are non-specific to malaria thus a malaria blood test is usually recommended to confirm the diagnosis.
When malaria is not promptly treated and the Plasmodium parasites overwhelm the red blood cells, a condition called severe malaria ensues. This is a life-threatening condition and when not expertly managed leads to permanent brain damage or death. The following are some symptoms and signs of severe malaria:respiratory distress, confusion / irrational behavior, multiple convulsions/seizures, loss of conscious/comaandmultiorgan failure.
Management of Malaria
Oral Artemisinin based Combination Therapy (ACT) is currently the most effective means of treating non-complicated malaria infection. In addition, other drugs are given to relief all the unpleasant symptoms of malaria which tends to prolong the length of medication beyond three days. Chloroquine used to be the drug of choice until it became less effective in treating a great percentage of people with malaria due to drug resistance.
There are also prophylactic drugs for travelers to malaria endemic regions in order to prevent malaria susceptibility. The same goes for children <5years old as well as pregnant women. This helps to sensitize the immune system against plasmodium infestation.
Prevention of malaria
The focus of malaria prevention is centered on preventing the proliferation of the vector as well as preventing bites from the female anopheles mosquito. These include:
Use of Long-Lasting Insecticide Treated Nets over sleeping beds or sleeping areas
Residual spray of insecticides on indoor walls.
Wearing long clothing that cover up hands and legs. This ensures there are less exposed parts of the body for mosquitoes.
Use of insect repellant oils, creams or sprays on exposed parts of the body.
Good hygiene also helps in keeping mosquitoes away as they are said to be attracted to strong body smells.
Eliminate all probable breeding sites for mosquitoes by getting rid of water puddles and stagnant water. Ensure to have free-flowing gutters, you may also put oils on surfaces of nonflowing gutters to prevent mosquito larvae from coming up for air.
Put lids on waste bins
Dispose of old and unused things that serve as breeding sites for mosquitoes including: tyres, tins, buckets, pots, cars…
Cut/trim over grown bushes
Houses should be constructed with mosquito preventive measures included such as inclusion of door and window nets as well as ensuring that there are no open spaces under doors and window openings.
Adopt a healthy lifestyle – exercise, maintain healthy eating habits and get 8 to 10 hours of sleep daily. This helps to boost the immune system and prevents easy susceptibility to infections.
Pregnant women in endemic areas are advised to take malaria prophylaxis during the course of their pregnancy.
Immunization – Antimalaria vaccines have long been researched and shown to offer some degree of malaria immunity to those vaccinated. The trial was done in. children and conducted for a four-year period.
Currently, the vaccines have been approved for public use starting with three pilot countries – Ghana, Malawi and Kenya. Already, the pilot phase has begun in Malawi.
Research source: who.int, cdc.gov, severemalaria.org