Imran Aamir Khan Bin Mohamad Rafi
Nur Syazani Amanina Bt Mohd Shahzan, Eion Brian Towle
Malaria is one of the most recurrent disease spread globally, particularly sub- Saharan Africa. Malaria is a life-threatening disease caused by parasites that are transmitted to people through the bite of an infected female Anopheles mosquito. It is caused by malaria vectors known as Plasmodium parasites. There are five parasites that typically expose humans to this disease. They are the P.falciparum, P. vivax, P. ovale, P. malariae, P. knowlesi. However, the P. falciparum is the most lethal species that attacks the body’s central nervous system. The P. falciparum can cause severe malaria because it multiples rapidly in the blood and can thus cause severe blood loss anaemia. In addition, the infected parasites can clog small blood vessels.2 When this occurs in the brain, cerebral malaria results, a complication that can be fatal. About three billion people are at risk of infection in 109 countries. Each year, there are an estimated 250 million cases of malaria leading to approximately one million deaths.3 Nevertheless, malaria is curable and it sure is preventable with the right measures.
Once a person is diagnosed with malaria they portray a variety of symptoms that differ for each individual. Early diagnosis of malaria is critical for a patient’s recovery. Any individual showing signs of malaria should be tested immediately. If left untreated, malaria can be fatal. The aim of treatment is to eliminate the Plasmodium parasite from the patient’s bloodstream.4
Symptoms of the disease begin to arise about 10 to 15 days after the infective mosquito bite for a non-immune individual. In certain cases, P. vivax and P. ovale can remain dormant in the liver for up to a year before causing symptoms.5 This causes the symptoms do not show up until a few months after the mosquito bite. Malaria symptoms can be classified into two categories. They are uncomplicated malaria and severe malaria. Both of these may have similar symptoms but are very much contrasting to one another. For uncomplicated malaria, the symptoms include cold, hot and sweating phases, fever, vomiting and headaches, seizures, fatigue, sweats. These symptoms usually occur every second day and last for up 6 to 10 hours. On the other hand, severe malaria shows symptoms of organ dysfunction which include impaired consciousness, abnormal bleeding, anaemia symptoms, jaundice, respiratory distress, multiple convulsions as well as many others.6 In people infected with P. falciparum, the following symptoms may also occur, extreme tiredness, delirium, unconsciousness, coma, kidney failure, pulmonary edema.5
As for vaccine, there is only one approved malaria vaccine which was approved as of 2015 which is RTS, S, the most recently developed recombinant vaccine. It requires four injections and it has a relatively low efficacy percentage which is about 26%- 50%. This translates to the WHO not recommending the use of this particular vaccine for babies between the age of 6 to 12 weeks. This vaccine is developed by PATH Malaria Vaccine Initiative (MVI) and GlaxoSmithKline (GSK).7 Treating malaria victims should be done tediously as it depends on several factors. Other treatments concern the use of continuous intravenous infusion. Most of the drugs used in the treatments are those which are active against the parasite. They include chloroquine, quinine, quinidine, doxycycline and many more.8 Apart from that, travellers could potentially prevent malaria by receiving antimalarial drugs based on the specific country of travel. However, consideration must be taken as no antimalarial drug is 100% preventative and must be combined in conjunction with self-preventative measures.9
Research from all different parts of the continent is still undergoing to develop the most efficacious cure to this lethal disease. Artemisinin-based combination therapy (ACT) is one of recent developments of malaria and is currently recommended for the treatment of P. falciparum malaria. The benefits of ACT are their high efficacy, fast action and the reduced likelihood of resistance developing.10 Secondly, indoor residual spraying (IRS) is another recent development which involves coating the walls and other surfaces of a house with a residual insecticide. For several months, the insecticide will kill mosquitoes and other insects that come in contact with these surfaces because malaria vectors are considered endophilic.11 Besides that, Insecticide-treated bed nets (ITN) is also a form of protection that has been shown to reduce malaria illness and death due to malaria in endemic regions. The insecticides that are used for treating bed nets kill mosquitoes, as well as other insects reducing the number of mosquitos that enter the house.12 The mass distribution of ACTs, IRS and ITN contributed toward the substantial decline in the number of malarial deaths worldwide. However, there are still many challenges and trials that still require attention. This is because these malarial parasites are able to get immune to insecticides as they undergo continuous mutation.
The future is much like a mystery to everyone. There are many possibilities as to what may come. Technological evolution has led to many breakthroughs in the medical sector. For example, surgeons from the Maastricht University Medical Centre in the Netherlands performed the first robot-assisted super-microsurgery in 2017.13 This particular breakthrough will certainly guide several other initiatives towards eradicating malaria. As time goes on, an effective cure will be discovered by researchers. In conjunction with that, the question whether malaria will be prevalent in certain regions would still persist as the unknown because the actions of mankind unceasingly cause changes to the Earth that may lead to undesirable outcomes. From my point of view, being immune to the disease would be a good start to a better future ahead. Not only that, but the number of deaths are drastically decreasing each year even though Africa has the most number of deaths. This shows that we are a step closer to eradicating this disease.
Percentage of death
WHO Fact sheet about Malaria Website. Viewed 2018 July 20 . Available at : http://www.who.int/news-room/fact-sheets/detail/malariaCDC- Malaria Parasites Website. Viewed 2018 July 21. Available at : HYPERLINK “https://www.cdc.gov/malaria/about/biology/parasites.html” https://www.cdc.gov/malaria/about/biology/parasites.html
Greenfacts. Malaria: 1. Introduction Website. Viewed 2018 July 21. Available at : https://www.greenfacts.org/en/malaria/l-2/1-public-health.htm#0Lolla Creative Studio. What is Malaria? – Website. 2016 November 7. Viewed 2018 July 21 . Available at : http://www.lolla.co.za/29488-2/Medbroadcast. Malaria – Causes, Symptoms, Treatment, Diagnosis Website. Viewed 2018 July 21. Available at : https://medbroadcast.com/condition/getcondition/malaria NDTV. World Malaria Day: Causes, Symptoms And Some Effective Steps To Prevent Malaria Website. Viewed 2018 July 21. Available at : https://www.ndtv.com/health/world-malaria-day-2018-causes-symptoms-and-some-effective-steps-to-prevent-malaria-1842039Wikipedia. Malaria vaccine Website. Viewed 2018 July 22. Available at : https://en.wikipedia.org/wiki/Malaria_vaccineCDC – Malaria – Diagnosis ; Treatment (United States) – Treatment (U.S.) Website. Viewed 2018 July 22. Available at : https://www.cdc.gov/malaria/diagnosis_treatment/treatment.htmlCDC – Malaria – Travelers – Choosing a Drug to Prevent Malaria Website. Viewed 2018 July 22 . Available at : https://www.cdc.gov/malaria/travelers/drugs.htmlMalaria Consortium – Artemisinin-based combination therapy (ACT) Website. Malariaconsortium.org. Viewed 2018 July 23. Available at : https://www.malariaconsortium.org/pages/artemisinin.htmCDC – Malaria – Malaria Worldwide – How Can Malaria Cases and Deaths Be Reduced? – Indoor Residual Spraying Internet. Cdc.gov. Viewed 2018 July 23. Available at : https://www.cdc.gov/malaria/malaria_worldwide/reduction/irs.htmlCDC – Malaria – Malaria Worldwide – How Can Malaria Cases and Deaths Be Reduced? – Insecticide-Treated Bed Nets Internet. Cdc.gov. Viewed 2018 July 23. Available at : https://www.cdc.gov/malaria/malaria_worldwide/reduction/itn.html Health24. 10 big medical breakthroughs of 2017 Website. Viewed 2018 July 23. Available at : https://www.health24.com/News/10-big-medical-breakthroughs-of-2017-20171127Roser M , Ritchie H . Ourworldindata.org. Malaria Website. Viewed 2018 July 23. Available at : https://ourworldindata.org/malaria