In 2013, 97
countries had an on-going malaria
transmission, informs Dr Neena Valecha, Director, National Institute of Malaria
Research, New Delhi. Keeping the huge
burden of malaria in mind, the World Health Organisation (WHO) picked the theme
'Invest in the future. Defeat malaria' for the World Malaria Day, April 25,
three-year theme for the period of 2013-2015, WHO targets to meet the 2015
Millennium Development Goals and fight back malaria
with an eye on making the
world malaria free.
With the aim of
spreading awareness, education and understanding about malaria and looking for
means to prevent and control it, the WHO started World Malaria Day in 2007.
Global Scenario of Malaria
WHO, India is one of the 10 countries in South-East Asia Region where malaria
is endemic and claims thousands of lives. And 40 per cent of the world
population which faces the risk of malaria reside in South-East Asia Region,
which houses a quarter of the world population.
mostly in poor, tropical and subtropical areas of the world. The Democratic
Nigeria, Republic of Congo and India are the worst affected countries.
According to WHO Director-General Margaret Chan, the fact that so many people
are infected and dying from mosquito
is one of the greatest tragedies of the 21st
Dr Valecha says,
"Globally, malaria is a major problem in African continent with Plasmodium
falciparum as the predominant species and very efficient malaria vectors. The
disease burden, including death, is mainly in children under 5 years of age in
weather conditions in Africa are such that transmission of the disease takes
place the entire year. Lack of proper resources and unstable socio-economic
condition prevent efficient malaria control activities.
WHO Statistics on Malaria
As per the WHO,
every year, over 200 million malaria cases are seen globally, but most of the
cases are never tested or registered. In 2012, there were approximately 207
million cases of malaria and 6,27,000 malaria deaths.
In 2012, malaria
killed an estimated 1,300 children everyday, or one child almost every minute.
of the world are working on eliminating the menace of malaria as it costs a lot
to human lives and resources. Approximately US$ 5.1 billion is needed every
year to fight back the disease. In 2012, total international and domestic
funding for malaria was US$ 2.5 billion.
A Lancet report
says that funds hindered the work of providing insecticide-treated
in sub-Saharan Africa, where 150 million nets are needed
annually to protect people from the malaria parasite. But only 70 million were
delivered in 2012. However, the situation improved in 2013.
there has been a 42 per cent decline in global malaria mortality rates. But
still a lot needs to be done.
Condition of Malaria in India
Unicef says that
in India, of the 1.2 billion people, 80.5 per cent reside in malaria-prone
areas. According to Dr Valecha, "In India, 22 per cent population lives in
areas with high transmission and approximately 30 per cent of disease burden is
reported from children."
With such huge
figures, India has a big task before it - to get free of malaria by 2015.
Malaria is the deadliest of all vector-borne
. About 10 per cent of the total cases of malaria are
reported from urban areas. Maximum numbers of malaria cases are reported from
places like Chennai, Vishakhapatnam, Vadodara, Kolkata, New Mumbai, and
in urban areas is a big problem due to unplanned expansion of cities and towns.
A surge in construction in cities has led to migration of workers to cities,
causing problems in sanitation and water storage in slums. All these lead to
spread of mosquitoes which transmit malaria.
As per details
on National Institute of Malaria Research website, Northeastern states (mostly
Assam, Arunachal Pradesh, Meghalaya, Tripura), tribal and forested parts of
Odisha, Jharkhand, Chhattisgarh, Madhya Pradesh, Maharashtra, Andhra Pradesh,
West Bengal and few districts in Karnataka and Gujarat report high malaria
The WHO put
malaria deaths in 2006 at 21,000, but a nationwide mortality survey in India
pointed out that these figures were too low and were underestimated.
A Lancet report
of 2010 said that malaria may be causing about 200,000 deaths a year in India
among people below the age of 70. Still, there has been a decline in malaria
cases in India. According to National Vector Borne Disease Control Programme,
there were 10,67,824 malaria cases in 2012 and in 2013, the figure was
Initiatives by Indian Government to Tackle Malaria
government launched the National Malaria Eradication Programme in 1958, Urban
Malaria was not a part of it. But by 1970s, the government found out that cases
of rural malaria came down while cases in urban areas went up. It was then that
the government started Urban Malaria Scheme in 1971.
is also taking steps to provide mosquito nets, medicines, etc. to people in
order to stop malaria from spreading. It is also spraying DDT to kill the
has also introduced rapid diagnostics and Artemisinin-based combination
medicine for treatment, apart from providing long-lasting insecticidal bed nets
for prevention," said Dr Valecha.
added that all these have been made available at the level of community health
workers who are given incentives for diagnosis and providing complete
But a setback
for India is the growing resistance to the antimalarial drug chloroquine
. Although the problem
is seen in the entire country, it is more evident in regions with intense P.
falciparum transmission such as North Eastern states, Odisha, construction
sites, big metropolitan areas and areas along international borders.
Symptoms of Malaria
malaria may appear in cycles. But initially, the symptoms are sometimes similar
to those of many other infections caused by bacteria, viruses or parasites. The
person may have fever
, sweats, fatigue, nausea
and vomiting, enlarged spleen, and muscle pain. In rare cases, malaria can even
affect functioning of brain or spinal cord, causing seizures or loss of
the P. falciparum parasite is more serious and may become life-threatening. If
not diagnosed on time, P. falciparum can be deadly as it is becoming
chloroquine-resistance, said experts.
The symptoms and
cycle of fever may vary with different parasites. Fever can occur every 48
hours if you are infected with P. vivax or P. ovale and it can come every 72
hours if you are infected with P. malariae. P. falciparum usually does not
cause a regular, cyclic fever.
Children and pregnant
women form the high-risk category and they should be very careful and watchful.
in forests, army troops and population living in remote inaccessible areas
which lack access to health services are more vulnerable to malaria, said Dr Valecha.
Prevention of Malaria
The best way to
protect yourself from malaria is to keep away from mosquito bites by being
vigilant and following certain guidelines.
A person should
stay inside when it is dark outside and wear protective clothes, such as long
pants and long-sleeved shirts.
One should use
insect repellent. One should use mosquito nets that are treated with
insecticide such as permethrin
or deltamethrin. But one should see to it that these insecticides are effective
against mosquitoes because in some areas, mosquitoes have become resistant to
permethrin and deltamethrin.
One should use
flying-insect spray indoors around sleeping areas. One should also take certain
anti-malarial medicines when travelling to regions affected by malaria.
caused by parasite called Plasmodium
, which is transmitted
through bites of infected mosquitoes. In the human body, the parasites grow in
liver and then infect red blood cells. Malaria is transmitted by an infected
female Anopheles mosquito.
According to Dr
Valecha, people need to work to get rid of malaria. She says that patients
should report to community health workers or health facility for proper
diagnosis of fever, in urban areas, patients should insist on diagnosis of
fever and not accept treatment empirically, doctors should give complete
treatment after diagnosis as per national guidelines and over-the-counter sale
of anti-malarials without prescription should be discouraged.
malaria can play an important role in our war against the deadly disease.
Though different quarters are working on the issue, it will take some time
before it is commercially available.