Malaria is a vector-borne (spread by organisms) pervasive infectious disease that is common in tropical and sub-tropical regions of Africa, Asia and the Americas. The World Health Organization estimates that at least 300 million cases of malaria occur worldwide annually resulting in more than two million fatalities.

Almost 90% of fatal cases are in sub-Saharan Africa, where the primary malaria mosquito, Anopheles gambiae is found. The most commonly found strain of malaria parasite, Plasmodium falciparum, causes severe, potentially life-threatening disease. The majority of casualties are children under 5 years of age; it is estimated that every 30 seconds a child in Africa dies as a result of malaria. Women are twice as likely to die from malaria if pregnant, and in general four times more likely to become ill than men.

Due to economic difficulties and political instability in many parts of sub-Saharan Africa it is very difficult to engineer and sustain effective malaria control programmes. Furthermore tests have shown that malaria parasites in many regions are becoming more resistant to anti-malarial drugs such as chloroquine. Chloroquine is regarded as the safest and cheapest drug on the market. However its potency is rapidly decreasing as a result of uncoordinated and fragmented treatment. Under such circumstances malaria is able to adapt quickly and become highly resistant to medication. However it has been shown that malaria deaths can be reduced with coordinated intervention.

Malaria can be prevented by:

• Keeping mosquitoes from biting you, particularly at night;
• Taking anti-malarial drugs to kill the parasites;
• Wearing insect repellent that contains 20% to 30% DEET (N,N-diethylmethyltoluamide) or dimethyl phthalate on exposed skin;
• Wearing long-sleeved shirts and long trousers if outdoors between dusk and dawn;
• Destroying places where mosquitoes breed; spraying insecticides, using insecticide dispensers that contain tablets impregnated with pyrethroids, or burning pyrethroid mosquito coils indoors at night;
• Sleeping under bed nets. This is especially effective if the bed nets have been treated with the permethrin insecticide; and
• Seeking medical treatment if travelers experience an unexplained fever while in or after returning from an area where malaria is common.

The purpose of malaria control is to prevent illness and death from malaria as well as to help prevent social and economic depletion by enhancing and augmenting regional and national capabilities. Four basic technical elements of malaria control are:

• To provide early diagnosis and rapid treatment;
• To plan and implement selective and sustainable preventive measures, including the control of mosquitoes that transmit malaria;
• To detect early, contain and prevent epidemics;
• To strengthen local capabilities in basic and applied research to permit and promote the regular reassessment of a country’s malaria situation, in particular the ecological, social and economic determinants of the disease.

In order to successfully implement malaria control strategies the following are required:

• Sustained political commitment from all levels and sectors of government;
• Malaria control to be an integral part of health systems and coordinated with relevant development programmes in non-health sectors;
• Communities to be full partners in malaria control activities; and
• The mobilisation of adequate human and financial resources.

Treatment

Currently there is no anti-malarial prophylaxis drug treatment than provides absolute protection from the malaria parasite, however sustained use of the drugs can reduce the risk of infection.

• Malaria can be cured with prescription drugs. The type of drugs and duration of medical care are entirely dependent on the strain of malaria diagnosed, the patient’s age, where the patient contracted the disease as well as the severity of illness at the start of treatment.
• Drug-resistant malaria is an increasingly challenging public health issue, particularly in African countries. The use of combination therapies where two or more varieties of anti-malarial drug helps to reduce the risk of the parasite developing resistance to the drugs in specific combinations.
• If properly identified, and adequately and promptly treated then malaria is certainly a curable disease. Thus far there has yet to be a vaccine approved for human use due to the complex nature of the parasitic organism and its life cycle. The parasite is in a state of constant change, making the development of an adequate vaccine very difficult.

Further Information

Further information about malaria, is causes and effects, can be found at the following websites:

• www.globalhealthreporting.org/malaria.asp
• www.malarianomore.org
• www.healthline.com
• www.malaria.org
• www.MMV.org
• www.malaria.me.uk
• www.malariacontrol.net