For over 50,000 years, malaria has infected humans. Currently, it infects 300-350 million people every year, making it one of the most common diseases. It is also one of the deadliest diseases in existence today, claiming an estimated 1,000,000 lives per year. The Guide to Malaria provides an overview of the disease, examines its symptoms and addresses its treatment as well as significant related concerns.
Caused by parasites in the genus Plasmodium, malaria is most often transmitted by infected mosquitos. Four major varieties of malaria exist, all of which are caused by different but related parasites. The major species of Plasmodium that result in human malaria are:
- Plasmodium falciparum
- Plasmodium vivax
- Plasmodium ovale
- Plasmodium malariae
The first species, Plasmodium falciparum, is responsible for nearly all malaria deaths. This variety is particularly threatening to those who have no background immunity, such as children or travelers. Having no defenses against the disease, these populations are more likely to develop severe life-threatening cases. The other varieties tend to produce much milder symptoms.
Many countries are not seriously threatened by malaria. For most, the potential to be infected remains possible but unlikely. Developing nations with warm, tropical or sub-tropical climates are at elevated risks for malaria. Widespread in Asia, the Americas and Sub-Saharan Africa, the disease thrives in environments that have large amounts of rainfall and consistently high temperatures. Additionally, high humidity and the presence of stagnant water are conducive to mosquito breeding. An environment that allows for continuous breeding enables infected species to perpetuate Plasmodium parasites.
Outside of ecological environment, poverty levels often predict malaria severity. A study conducted by the IZA supports the idea that poverty and malaria are correlated. Conducted by Christian Zimmerman and Douglas Gollin, the investigation sought to understand the connections between ecological differences associated with malaria prevalence and economic success. They found that it is possible for a “malaria trap” scenario to develop, resulting in a greatly reduced (halved) income per capita. Gallup and Sachs made a similar attempt to understand the correlation between poverty and economy in their study, “The Economic Burden of Malaria,” which found that 44 countries with intensive malaria burdens had a per capita income of $1,526, compared to $8,268 for those without intensive malaria burden. Tropical environment and poverty factor heavily into the prevalence of malaria. The disease is an especially significant problem in Sub-Saharan Africa. The region experiences 90 percent of the world’s malaria related deaths; 85 percent of those deaths include children under the age of five.
Symptoms and Effects
The most common symptoms of malaria are not especially distinctive. Primary symptoms include:
- Flu-like symptoms
With initial symptoms consisting of headache, fever, and vomiting, it may be easy to overlook infection. Potentially deadly, this disease should be treated seriously by those who fear they may have contracted it. Once an individual is infected, the parasites multiply in the liver and eventually infect red blood cells.
Even in cases where it is not deadly, malaria can result in myriad health conditions and cognitive issues. In some instances, severe episodes can cause extreme long-term physical and neurological impairment. Negatively affecting multiple systems and marked by neurological complications, cerebral malaria results in many acute symptoms. In such severe cases, children often experience seizure, while adults experience acute renal failure, pulmonary edema and liver dysfunction. A specific severe type known as cerebral malaria is considered to be one of the most common non-traumatic diseases of the brain world-wide
Another problem related to malaria is the development of anemia in children. Those affected experience poor growth and underdevelopment, potentially resulting in a lifelong struggle with fatigue and weakness. Pregnant mothers who develop malaria are at risk for birthing low-weight infants, which is a major factor for infant mortality.
Treatment and Concerns
Malaria can be treated with medicine, but it is much more effective to practice preventative rather than reactionary measures. Often, those who live in areas prone to malaria have developed immunities to the disease, which explains the high rate of incidence among children. In day-to-day activities, using insect repellents and covering skin can greatly reduce the chances of being bitten by infected mosquitoes. In cases where reactionary medicine is necessary, doctors may proscribe any number of anti-malarial drugs. Currently, severe malaria is treated with quinine or artesunate. Studies show that artesunate results in lower mortality rates than quinine and is less resisted by Plasmodium parasites.
With the use of anti-malarial medicine, many are concerned that Plasmodium parasites will become resistant. The potential results could be devastating to anti-malarial efforts, effectively nullifying the benefits of medicine. Resistance has been found in nearly all available anti-malarial drugs. Displaying an exceptional ability to resist drug treatments, the parasites responsible for malaria may become immune to current methods. Current academic interest on the subject shows positive signs; recent research from the Harvard School of Public Health has revealed several specific genes that are responsible for the parasites’ ability to resist modern drugs.
One of the greatest challenges to preventing further issues surrounding malaria is assessing the full scale of the problem. Though health professionals are generally informed regarding the visible impacts of the disease, its ambiguous symptoms and the lack of action taken by those affected obfuscates the true extent of malaria. An assessment of the malaria situation in Africa, The Africa Malaria Report 2003 conducted by the WHO and UNICEF, is helpful in better understanding the extent of the problem as well as its severity.
Due to the severity of malaria, many organizations are devoted to raising awareness and improving preventative measures. The World Health Organization is a leading group in improving the malaria epidemic; it is responsible for conducting research and educating the world about the concerns surrounding the disease. With an emphasis on ensuring the well-being of children, UNICEF is another prominent group in malaria related advocacy. A collaborative effort, the Intermittent Preventative Treatment in Infants (IPTi) is another organization dedicated to better understanding the problems posed by malaria and how to solve them.
The following resources complement information provided in this guide, allowing for a more complete understanding of the topic.
Image courtesy of Wikimedia Commons, author: James D. Gathany