Malaria Prevention

MALARIA

Malaria is a parasitic disease which is spread from person to person by the bite of an infected Anopheles mosquito.   Historically, malaria has existed throughout most of the tropical and temperate world, but over the past 100 years, malaria has been eradicated from much of Europe and North America.  The map below shows the current areas of the world where malaria is present.

Malaria Statistics

  • Malaria is a disease which affects 109 countries around the world.
  • There are between 250 million and 500 million cases of malaria each year around the world.
  • One million people die from malaria each year–most of them children.
  • The vast majority of malaria cases around the world occur in sub-Saharan Africa.
  • 90% of all malaria deaths occur in sub-Saharan Africa.
  • When insecticide-treated mosquito nets are used properly by three-quarters of the people in a community, malaria transmission is cut by 50%, child deaths are cut by 20%, and the mosquito population drops by as much as 90%.
  • It is estimated that less than 5% of children in sub-Saharan Africa currently sleep under any type of insecticide-treated net.

Types of Malaria

There are four types of malaria that infect human beings:

  • Plasmodium malariae
  • Plasmodium ovale
  • Plasmodium vivax
  • Plasmodium falciparum

Of these four types, Plasmodium falciparum is by far the most dangerous type.  It is the type of malaria which is responsible for the majority of deaths from malaria.

Malaria Life Cycle

When a person is bitten by a malaria-infected mosquito, the malaria parasites enter the blood stream and go directly to the liver.  In the liver they mature and develop for a variable period of time. When the parasites have matured, they are released into the blood stream.  It is at this time that the person becomes symptomatic with malaria.  The parasites now enter the red blood cells, where they develop and multiply.  Eventually, the blood cell ruptures and the parasites are released once again into the blood stream to infect many other red blood cells.  Some of the parasites enter a sexual reproduction stage when then make them ready to be picked up by another mosquito and the life cycle begins again.

Treatment of Malaria

The treatment of P. malariae, P. vivax and P. ovale can frequently be done on an outpatient basis using antimalaria medications.  However, the treatment of P. falciparum usually required intravenous medication given in a hospital or health centre.  Many drugs have been used to treat malaria, however, resistance to these drugs have developed in the parasite and now it is standard practice to use at least two different drugs in the treatment of malaria.  Some of the drugs used to treat malaria are:

  • Quinine
  • Chloroquine
  • Amiodaquine
  • Pyrimethamine
  • Proguanil
  • Sulphadoxine
  • Mefloquine
  • Doxycycline
  • Clindamycin
  • Lumafantrin
  • Artemisinin and derivatives
  • Atovaquone
  • Primaquine
  • Halofantrine

A correct diagnosis should be made by a medical professional, the type of malaria should be identified and the correct treatment chosen by someone who is familiar with the diagnosis and treatment of malaria.

Prevention of Malaria

All travellers to countries where there is a risk of malaria, should take medication to prevent malaria.  The main medications used to prevent malaria are:

  • Chloroquine Phosphate This is only valid for countries which have no P. falciparum malaria.
  • Mefloquine
  • Doxycycline
  • Malarone

It is also important to keep oneself from being bitten by mosquitoes.  This should be done by the use of DEET-containing insect repellants which should be used from late afternoon until early morning.  Clothing can be soaked in Permethrin prior to travel to prevent mosquitoes from biting through one’s clothing.

Since malaria-transmitting mosquitoes (Anopheles mosquitos) are night-time feeders, it is important to sleep under a permethrine-impregnated mosquito net which is in good repair and which is properly used.  Only 5% of African children, who are the most at risk of dying from malaria, regularly sleep under a mosquito net.

PROLASA Project

PROLASA is promoting the use of mosquito bed nets by all children.  A mosquito net costs approximately $10.  Many families is eastern Congo live on less than $200 / year.  They cannot afford to buy mosquito netting.  If you would like to buy a mosquito net for a child in Eastern Congo, please contribute by going to the contributions page.