While we pour our thoughts into another World Malaria Day, it is about time to take stock of the strategies adopted to quell the disease, which has often made a mockery of the efforts undertaken by scientists the world over.
Malaria is a disease that is set into action by the protozoan parasites of the genus Plasmodium and is considered a lethal vector borne disease. Four species of Plasmodium triggers the disease in several forms. They are Plasmodium falciparum, Plasmodium vivax, Plasmodium ovale, and Plasmodium malaria. P. falciparum is by far the most common and perilous of the four types; in the absence of proper treatment it can cause fatal cerebral malaria.
Malaria parasites are conveyed from one person to another by the female anopheles mosquito which is found mainly in tropical and sub-tropical areas. Like all other mosquitoes, the anopheles grows and multiplies in water. An infected anopheles mosquito spreads the infection by injecting the malarial parasites into the blood of a person it bites. The malarial parasites course through the bloodstream and find their way to the liver, where they attack the red blood cells.
Malaria is detected with the help of blood tests and evaluation of clinical symptoms. The symptoms show up as fever, shivering, pain in the joints and headache, which can be offset with anti-malarial drugs, capable of annihilating the parasite. In some places, the parasites have mutated to complex forms, developing a resistance to antimalarial drugs, especially chloroquine. Therefore elaborate, expensive and evolved treatment is required in such cases to kill the parasite.
It is estimated that nearly 300 million people worldwide are affected by malaria and between 1 and 1.5 million deaths take place annually due to the disease. In the past, malaria was rampant in many parts of the world, but today it is predominant in Africa, Asia and Latin America. In endemic regions, where people are susceptible to the disease, the infection is so common that people also develop gradual immunity to the disease. Yet, children and pregnant women need to be cautious, as they are prone to the infection due to reduced immunity.
Evolving effective malaria control programmes in vulnerable areas has been a challenge due to nascent health frameworks and extremely low socio economic surroundings. These problems have only escalated, with the parasite proliferating to a virulent form, defeating the host of anti-malarial drugs. Researchers are adopting a three pronged approach to combating malaria- newer medicines, changes in the environment, and development of vaccines. The World Health Organisation has made it a point to provide insecticide treated mosquito nets to many vulnerable tropical areas which has undoubtedly benefited the malaria control programme. Trials for the malaria vaccine are underway and scientists are hopeful of realising the vaccine by 2010. Research into drugs that can surmount drug resistant malaria is an ongoing process, a challenge to scientists to beat the parasite at its own game.
Essentially all control strategies should address the following objectives:
- Enabling quick diagnosis and immediate treatment to people at risk
- Adoption of preventive measures including vector control programmes, insecticide treated mosquito nets and improving surroundings
- A quick action plan to respond to epidemics
- Ample and correct information about risk prone areas, population and vectors
It must be understood that it is possible to save lives if the disease is detected early and properly treated. The need of the hour will be to effectively use the strategies and methodologies at hand and reflect them in effective prevention, diagnosis and treatment, that is designed to suit typical conditions and environments.