“Verwekker van malaria
Sing maar Jou laaste aria –
Nog een minuut vir grasie.
Al soebat jy nou nog so lang,
Al se jy ook: ek is nie bang,
Nooit sien jy weer jou nasie…”
– Extract from Muskietejag a Afrikaans poem by Deur A.D. Keet
from his book Gedigte (1920)
Malaria: A Persistent Threat
Mature, malariae, schizont, old, trophozoite photo by Steven Glenn, Laboratory and Consultation Division, USCDCP
Malaria is a mosquito-borne infectious disease that remains a significant public health concern globally. It primarily affects tropical and subtropical regions, causing immense illness, disability, and death, particularly among young children. It infects mammals, birds and reptiles with a combined number of more than 125 species of malaria. First symptoms recorded that resemble that of malaria date back to 413 B.C., the word Malaria is derived from one Italian that associated with “bad air”. The first well documented infection in South Africa may have been that of Louis Trichardt Maputo trek between 1837-1838.
According to the World Health Organization (WHO), in 2022, an estimated 241 million cases of malaria occurred worldwide, and an estimated 630,000 people died from the disease.
Transmission and Life Cycle
The parasite responsible for malaria, Plasmodium, is transmitted through the bites of infected female Anopheles mosquitoes. When an infected mosquito bites a human, the parasite enters the bloodstream and travels to the liver. Inside the liver, the parasite matures and reproduces, before bursting out and infecting red blood cells. Within red blood cells, the parasite continues to multiply, causing the characteristic symptoms of malaria.
Symptoms and Complications
The classic symptoms of malaria include fever, chills, sweating, headache, muscle aches, fatigue, nausea, and vomiting. However, symptoms can vary depending on the severity of infection and the specific Plasmodium species involved. Plasmodium falciparum is the deadliest malaria parasite and can cause severe complications, including severe anaemia, cerebral malaria (affecting the brain), and death, particularly in young children and pregnant women.
Prevention Strategies
Fortunately, malaria is both preventable and treatable. Here are the key approaches:
- Vector Control: Reducing mosquito populations and preventing bites are crucial. This involves using insecticide-treated bed nets (ITNs), indoor residual spraying (IRS) of insecticides, and environmental modification to eliminate mosquito breeding sites. The World Health Organization recommends universal coverage with ITNs for all people at risk of malaria.
- Chemoprophylaxis: Travelers to malaria-endemic regions can take antimalarial medications to prevent infection. These medications must be started before travel, continued during the trip, and for a specific period after returning. Consulting a healthcare professional or travel clinic is essential to determine the appropriate antimalarial medication regimen.
- Personal Protective Measures: Individuals living in or travelling to malaria-prone areas should take personal protective measures to avoid mosquito bites. This includes wearing long sleeves and pants, using insect repellent with DEET or other approved ingredients (IR3535 or Picaridin), and staying indoors during peak mosquito-biting hours (dusk and dawn).
Treatment
Early diagnosis and treatment are critical for a successful outcome. Rapid diagnostic tests are used to confirm malaria infection. Treatment involves antimalarial medications specific to the type of Plasmodium parasite and the severity of infection. Artemisinin-based combination therapy (ACT) is the most effective treatment for malaria, particularly Plasmodium falciparum infections.
Challenges and the Future
Despite significant progress, malaria control faces challenges. The emergence of drug-resistant parasites and insecticide resistance in mosquitoes pose significant threats to malaria elimination efforts. Continued research and development of new antimalarial drugs, vaccines, and improved vector control methods are crucial for eliminating malaria. A promising development is the RTS,S malaria vaccine, the first vaccine to be recommended by WHO for widespread use among children living in areas with moderate to high malaria transmission.
In Conclusion
Malaria is a preventable and treatable disease. By implementing effective prevention and control strategies, ensuring access to early diagnosis and treatment, and investing in research, we can significantly reduce the burden of malaria and work towards a malaria-free future.
Citations:
- World Health Organization. (2023). Malaria. https://www.who.int/news-room/fact-sheets/detail/malaria
- Centers for Disease Control and Prevention. (2023). About Malaria. https://www.cdc.gov/parasites/malaria/index.html
- World Health Organization. (2022). World Malaria Report 2022. https://www.who.int/teams/global-malaria-programme/reports/world-malaria-report-2022
- Centers for Disease Control and Prevention. (2023). Malaria Medications for Travelers. https://www.cdc.gov/malaria/travelers/drugs.html
- World Health Organization. (2023). World Malaria Report 2023 (to be published). https://www.who.int/teams/global-malaria-programme/reports/world-malaria-report-2022
- Scientific American. (2000). When was malaria first discovered and by whom? How is the disease transmitted? What are its effects?. http://scientificamerican.com/article/when-was-malaria-first-di?utm_source=pocket_shared
- University of the Witwatersrand, Coetzee, M. Malaria in South Africa: 110 years of learning to control the disease. https://www.scielo.org.za/scielo.php?pid=S0256-95742013001000029&script=sci_arttext&utm_source=pocket_reader