Let’s Draw The Line against Malaria
The facts are damning and the statistics frightening. According to the World Health Organization (WHO), 229 million malaria cases were estimated worldwide in 2019, with 409,000 deaths. More than two-thirds (67%) of these deaths were found in children under 5. In 2018, the fatalities stood at 411,000. While the Coronavirus pandemic may have dwarfed the figures for 2020, tuberculosis remains the only disease that kills more people than malaria every year.
The fight against malaria is global, and some wins have been recorded as actions have averted between 1.5 billion and 7.6 million malaria deaths since 2000. In the past twenty years, the death rate in Africa has been slashed by 44%, although Sub-Sahara Africa still has the highest mortality rate due to the disease, with 384,000 deaths (out of 409,000 worldwide) in 2019 alone. From the 2019 World Malaria Report, Nigeria alone accounts for almost one-fourth (23%) of all malaria deaths recorded that year.
These preventable deaths make it paramount that more efforts are taken to increase further the number of countries that have successfully eliminated the disease. This number stands at twenty-one, with eleven countries being certified in the last twenty years.
Malaria is transmitted from person to person when bitten by a female Anopheles mosquito with over 400 species and more than 30 being vectors of Plasmodium parasites that cause malaria. About 50% of the world’s population is at the risk of contracting the disease in 2019; however, of intense risk perennially to this disease are infants, pregnant women, children under the age of 5, and HIV/AIDS patients.
Tropical counties with their humid rainy seasons favor the lifecycle of mosquitoes to increase and thus the parasite to be fully developed for infection of the human hosts. These seasons avail diverse collections of small pockets of freshwater from the rain in puddles, broken containers, leaf surfaces, and other minor temporary or permanent water collecting bodies. These surfaces and materials foster the development and transmission of female Anopheles mosquitoes, which breed on these surfaces.
Mosquitoes lay their eggs in these water spots, which hatch into larvae, develop into pupae, and ultimately transform into fully developed adults with wings capable of sucking human blood for ingestion as food. During ingestion, the mosquito picks up the Plasmodium parasites from an infected human and deposits them into an uninfected person. One may be a carrier without necessarily showing symptoms if the load of the parasites in the body has not exceeded the carrying capacity of the host.
The most important means of preventing and reducing the transmission of this disease has been vector control. This involves limiting or eliminating the vector of this disease, the female Anopheles mosquito. Insecticide-Treated mosquito nets (ITNs) and indoor residual spraying are effective against the vector, especially in Sub-Sahara Africa, where the vector’s long life span and strong biting habits have continuously ensured a high incidence of malaria — 90% in 2019.
Insecticide and Treated Mosquito Nets
In Africa, this control method has increased from 2% in 2000 to an estimated 46% in 2019. It has helped to cut mortality rate by 44% in that timeframe. The usage of nets has also helped to stem the infection rate,n especially in pregnant and nursing women, driving down the infection rate in children under the age of 5 who are particularly prone to malarial infection.
However, indoor residual spraying has dropped from 5% in 2010 to 2% in 2019 due to the vectors’ buildup of resistance against it. The pyrethroid-based insecticides are being found to be ineffective against the vectors as the mosquitoes have continuously built resistance against them. Thus, there has been a steady shift from these insecticides to more effective ways to combat the spread of these vectors.
Antimalarial drugs have been developed to prevent contracting malaria disease. The development of antimalarial vaccines have also seen a 40% prevention rate amongst children. Individuals can now take antimalarial drugs and vaccines before embarking on a trip to a location where malaria is endemic. Many white foreigners were often killed by malaria than wars during the years of forays into the African and South American continents. That’s why it’s a requirement to get malaria shots before traveling out of some countries.
How Can We Draw the Line against Malaria?
If prevention which requires eliminating the vectors, is not achieved, we may not achieve a zero line in malaria. However, because the mosquitoes are mere vectors, removing the Plasmodium parasites can also help realize a zero line because there will be no parasites for the mosquito vectors to transmit across the populace.
The third goal of the United Nations Sustainable Development Goals is enshrined in: Ensuring healthy lives and promoting wellbeing for all ages and making the specific mention of malaria to be ended by 2030; and Reducing the mortality rate of children under the age of 5 which is greatly influenced by malaria infection.
To achieve this, a continuous synergy must be held among all the players with increased funding for research into novel ways to combat the disease and provide better drugs to prevent deaths.
Author: Oluwafemi Salako