5 Things You Should Know About Malaria
Caused by a parasite that is transmitted to humans by mosquitos, malaria threatens the lives of millions of people around the world.
Nearly half of the world’s population is at risk of falling ill with the life-threatening disease malaria. The disease is transmitted to humans by female Anopheles mosquitos, of which more than 400 species exist (approximately 30 are malaria vectors). Malaria infects the liver and subsequently red blood cells with parasites that fly under the radar of our immune systems, causing nonspecific symptoms including fever, headache, vomiting, and chills. If not treated promptly and adequately, malaria can lead to severe illness and often lead to death. The disease has been eradicated in most developed countries, but remains one of the most severe public health problems worldwide — in fact, it is a leading cause of death and disease in many developing countries.
1) Malaria is most prevalent in sub-Saharan African countries
In 2017, 92% of reported cases of malaria were reported in Africa.
Countries in Africa carry a disproportionately high share of the global burden of malaria. The vast majority (approximately 90 %) of malaria cases and deaths are concentrated in just 11 countries — 10 on the African continent and India. Approximately 70% of malaria deaths occur in young children — and children under 5 are at particular risk. Around the world in 2017, approximately 266,000 children did not see their fifth birthday because of malaria.
Malaria transmission is most common in warmer climates close to the equator where mosquitos thrive in densely populated areas. A longer lifespan allows the malaria parasite inside the mosquito to develop into a form that is dangerous to humans.
2) Malaria is preventable and curable
Global mortality rates have decreased by 29% among all age groups since 2010.
There are no vaccines to prevent malaria (although a vaccine with promising lifesaving potential for young children is currently being researched and piloted), but transmission of malaria can be reduced and even effectively prevented in other ways.
Most importantly, so-called vector-control interventions include the distribution and use of insecticide-treated mosquito nets and indoor residual spraying once or twice a year. Nets significantly reduce risk because Anopheles mosquitos predominantly feed at night. In 2017, half of the people in areas at risk slept protected by a net, compared to approximately 29% in 2010. An additional beneficial personal protection measure is the use of topical insect repellants and insecticide-treated clothing.
The WHO has developed a set of 20 global guidelines to provide evidence-based recommendations for effective malaria vector control to technical experts, policy makers, and researchers, so that they can design efficient vector-control strategies.
If treated in a timely and adequate manner, most malaria patients make a complete recovery. Early diagnosis and prompt appropriate treatment are critical. If malaria is suspected, a parasitological test can confirm the diagnosis, and anti-malarial medicines — administered intravenously, intramuscularly, and/or orally, often in combinations of at least two types — can effectively treat the disease. Malaria parasites are growing increasingly drug-resistant, so the use of anti-malarial medicines should be limited to confirmed cases of malaria, and patients should be encouraged to adhere to treatment in full.
What treatment for malaria looks like exactly depends on a variety of factors including the specific type of parasite and severity of the disease. Pregnant women, infants and young children, and people living with HIV, and people co-infected with tuberculosis are considered special risk patients that may require specialized treatment.
When someone falls ill with malaria, treatment should begin within 24 to 48 hours of the onset of the first symptoms. Unfortunately, half of the world’s population does not have access to health care.
3) The risk of malaria significantly increases in times of disaster
Vector-borne diseases, including malaria, are increasingly likely to spread following disasters, whether natural or man-made. Humanitarian emergencies often drive displacement of large numbers of people. These people may move to new environments where diseases are more common or they are exposed to new strains of diseases their immune systems are not prepared for. Malaria outbreaks are also more likely to happen because vector control activities are complicated by disasters — people may not have access to adequate shelter, let alone mosquito nets.
The Indonesian earthquake and tsunami of September 2018
Malaria is a particular concern after meteorological disasters such as cyclones and hurricanes that cause flooding. Standing water can create optimal conditions for mosquito breeding sites, since Anopheles mosquitos lay their eggs in water. The mosquito population can very rapidly increase and spread disease. Project HOPE responded to the critical medical needs in Palu, Indonesia after a massive earthquake and tsunami destroyed the lives of thousands of women, children, and men.
As part of our response, we partnered with UNICEF to launch a program providing malaria preventative services to internally displaced Indonesian families in Central Sulawesi.
Through March 2019, we have distributed a total of 101,502 bed nets to tsunami survivors.
4) Project HOPE is currently monitoring the risk of malaria in two humanitarian crises
An upsurge of malaria due to the Venezuelan Crisis
A potential malaria outbreak lurks in Colombia — the country that has taken in the vast majority of Venezuelans who have fled their country. Our team in Colombia has reported seeing an upsurge of malaria cases.
The threat of a malaria outbreak in Mozambique after Cyclone Idai
Mozambique is one of the 11 so-called high burden countries that carry approximately 90% of the global burden of malaria. Recent Tropical Cyclone Idai left large parts of the coastal city of Beira flooded and thousands of people displaced. Experts fear a potential major outbreak of malaria in the storm’s aftermath, as confirmed cases of the disease are rising.
5) Progress is being made but we must act now
In 2017, an estimated 435,000 people died from malaria globally — that’s 172,000 fewer deaths than in 2010.
Incidence rates of malaria were steadily declining over the past years — from 72 cases per 1000 population at risk in 2010, to 59 cases more recently. But for the past three years, progress appears to be at a standstill, and in some regions malaria is even on the rise. Apart from the fact that malaria-causing mosquitos cannot be contained or easily eradicated, malaria is particularly difficult to combat because interventions depend heavily on political commitment, financial resources, and public health infrastructures.
Major goals outlined in the WHO Global Technical Strategy for Malaria 2016-2030 are reducing the case incidence and death rates by at least 40% from 2015 levels by 2020. Currently, we are not on track to hit these milestones. In order to get back on track to hit 2025 targets, efforts must be intensified — specifically in 11 high-burden countries. Accordingly, the WHO is calling for an urgent global response and support for a new aggressive approach through the “High burden to high impact” program, led by countries most significantly affected by the disease.
The time to focus on course correction in the fight against malaria is now.
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