About Malaria One of the Oldest and Deadliest Diseases of the Past

Abstract

Malaria one of the oldest and deadliest diseases of the past, has affected and infected millions of people throughout history and continues to do so even now. In one way or another, the devastating effects of malaria still persist through this day at an alarming rate, spreading from individual to individual through anopheles mosquitoes as its vectors. Over the past decades efforts to manage and control malaria include antimalarial drugs, insecticides, vaccines, etc. Although the development of effective vaccines for malaria continue, none have been shown to provide long lasting benefits for treating the disease. Through the use of increased resources, support and societal commitment from regional collaboration will have a great impact on the present strive for a malaria free world.

Introduction

Malaria has been a global health issue dating back thousands and thousands of years, making it one of the leading causes of death across the world and throughout time. Malaria is a vector borne parasitic tropical disease found in over 90 countries around the globe, caused by infection through the microscopic parasite Plasmodium(MalariaNoMore). While transmission of malaria was still unknown before 1880, its effects around the world were catastrophic, killing millions of people especially in those countries with low economic status and resources. Though it was once an epidemic in the United States, malaria is currently confined to more tropical and subtropical environments, particularly in Africa and parts of Asia(Malaria, 2004). It is in Africa where the malaria parasite is believed to have originated although it has yet to be proven. Being a disease of the poor, malaria sill continues to cause distress by weakening people afflicted with the disease and causing significant financial costs to both the people affected and their governments. Efforts to control and reduce the prevalence of malaria continue up until this day through the development of new tools and innovations, including vaccines, novel antimalarial drugs and even by educating the public about the biology of the disease hoping to prevent people from contacting the disease.

History and Origin

Malaria is an acute febrile illness with an incubation period of 7 or more days. Thus, meaning any febrile illness developed in less than a week after first exposure cannot be classified as malaria. Caused by the protozoan plasmodium, human malaria is specifically caused by four different species of plasmodium; P. Falciparum, P. Malariae, P. Vivax and P. Ovale(W.H.O). The history of the human malaria parasites begin in 1880 when Alphonse Laveran, a french physician and pathologist, discovered the parasites in the blood of malaria patients. Being one of the oldest diseases, malaria dates back to ancient times having been referenced in documents, clay tablets and egyptian papri as early as 1500 BC. For thousands of years malaria was thought to have been caused by miasmas rising from swamps, which is where the word malaria comes from, in italian mal’aria meaning spoiled air until later proven it was actually an infection caused by a parasite(Parasites & Vectors). Through the discovery of bacteria and the incrimination of microorganisms as causes for the infectious disease as well as the development of the germ theory of infection, the really causes for malaria came to light. Thereby, after the discovery of the malaria parasites by Alphonse Laveran scientific studies began hoping for a better understanding regarding the parasites composition and possible treatment..

While some research still debates the origins of malaria, many believe its origins lay in primate chimpanzees. Theorizing, a mosquito fed on a chimpanzee carrying the parasite and then fed on a human, introducing the parasite into the human lineage(TheOriginOfMalaria). Given that parasites generally evolve towards a benignant relation with their hosts, indicates and supports evidence of chimpanzees having the malaria parasite far longer. As malaria is less virulent in chimpanzee and has been found to been around longer than that of humans, consists with resarch of the current studies supporting evidence that the parasite was transmitted from a chimp through a mosquito serving as a vector for the disease. While research is still skeptical on the origins of the parasite, its effects on the world have been more than noticeable without a doubt, being credited with millions of deaths around the world.

Vector & Environmental Control

In the past despite the accumulated knowledge and understanding, malariologists were not able to determine how it was that the malaria parasite spread from person to person. Over time however, the evidence began to gather suggesting a connection between anopheles mosquitoes and the malaria parasite. It wasn’t until 1883 that an american physician by the name of Albert King assembled all the evidence linking malaria and mosquitoes, creating the malaria-mosquito doctrine. Eventually, leading to Ronald Ross, a british doctor, concluding that human malaria was in fact transmitted by anopheline mosquitoes, all while working in Sierra Leone in 1899. While people usually get malaria through mosquitos, transmission of the disease can also occur through organ transplants, transfusion, shared use of needles and syringes contaminated with malaria tainted blood. Another way malaria may be transmitted is from a mother to her unborn child during or before delivery also known as congenital malaria, very common in areas with high malaria infection rates.

With the discovery of mosquitos being used as vectors for transmission/spreading of malaria, provided malariologist with new ways to combat the ancient disease(Parasites & Vectors). Over the decades after mosquitos were found to be the vectors for malaria, the possibility/idea for controlling the disease grew, leading to the development of new methods for prevention, including avoidance, screening, draining mosquito habits, mosquito proofing homes and even anti mosquito measures such as the use of larvivorous fish and oils. Although such methods have helped with the prevention of the disease, a definite solution sill needs to be reached.

As malaria attacks millions around the world, it not only affect those infected but the governments and countries themselves, impeding economic development and growth, particularly the rural poor and developing countries. By the early 1990’s, malaria had been controlled and confined in many parts of the region through the use of environmental management for vector control. Depending on the specific settings and circumstances for infection there are a series of vector control methods essential for malaria prevention. Vector control implementations have been seen to be effective in reducing and/or interrupting malaria transmission/spreading. The two main measures for malaria vector control are indoor residual spraying(IRS) and long lasting insecticidal nets (LLINS). An IRS vector control involves the spraying of insecticide in the indoor walls and ceilings of the home/residence. Although DDT, a common insecticide used to combat malaria, was banned in 1972 for its potential health effects, its uses for malaria control were highly effective. According to the United States National Academy of Sciences, DDT is credited with saving over 500 million lives before it was banned. The refining of insecticidal vector control measures could also considerably reduce insecticide resistance from mosquitos and provide effective malaria control. LLINS along with an effective insecticide have also been proven to reduce contact with mosquitos by providing a barrier and insecticidal effect for the prevention of the disease carrying insects.

Medical Treatment

The treatment of malaria is entirely dependent on the infecting malarial parasite specie, the severity of the infection and the geographic area of acquisition all of which affects the likelihood of drug resistance from the parasite(Malaria, Kathryn). Based on the severity of the infection an individual infected may require immediate medical attention and rapid initiation of antimalarial therapy. If an individual’s parasite type cannot be determined however, it is then assumed to be drug resistant P. falciparum malaria until proven otherwise. People infected with severe falciparum malaria and those unable to handle oral regimens require parental therapy(Malaria, Kathryn). An uncomplicated from of falciparum malaria can be treated through oral therapy. The choice of antimalarial drugs for treatment is dependent on the likelihood of infection with the drug resistant malaria strain. For P. vivax malaria parasite and P. ovale infection includes a course of chloroquine, a type of antimalarial drug, followed by 14 days of primaquine to eradicate hypnozoites and prevent relapses of the disease(Malaria, Kathryn). An infection caused by P. malariae however, is much easier to treat, usually with chloroquine alone, except however, in certain regions where there are resistant strains of malaria. The common antimalarial drugs for treatment of malaria include, atovaquone proguanil, chloroquine, doxycycline, mefloquine, primaquine, quinidine and quinine all of which have various aversive effects and their use depends on the specific malaria parasite being targeted and treated.

Summary

While malaria continues to attack the world as a vicious disease of the past, efforts for control strive at eradication. Knowing malaria spreads through anopheles mosquitoes has made it easier for malariologist to develop and implement better prevention methods. Prevention methods including the use of indoor residual spraying(IRS) and long lasting insecticidal nets(LLIN) as nets for vector control. The world health organization however, still seeks to educate the public on the disease and its prevention methods, particularly in developing countries were malaria continues to spread at an alarming. With the public becoming aware of how big of an issue malaria really is, will have a great impact on its control and prevention in the future. The implementation of insecticides in the future will also play a big part on the advance and control of malaria in the world.

Being an acute febrile illness with an incubation period of 7 or more days, immediate treatment is nearly impossible until symptoms develop after the incubation period. Treatment for malaria depends on the species of the infecting malaria parasite, geographic area in which an individual’s been infected and its severity, all of which affect the likelihood of drug resistance during treatment with antimalarial drugs and therapies. Depending on the specific type of malaria strain, treatment can range from simple oral therapy to immediate medical attention and rapid initiation of antimalarial therapy. As malaria is still an ongoing disease immunity from the strain to antimalarial drugs has become an issue when treating patients with the disease, especially in regions with high infection rates. With the disease still continuing to mutate and adapt to the current treatment it will make it difficult for future control. The development of vaccines with lasting benefits for treatment will have a tremendous impact on the future and the prevention of the parasite. Future implementations to fight malaria could also potentially include the malaipulation of mosquito genomes, creating mosquitos who are incapable of transmitting the malaria parasite from person to person. While the idea of mosquito genome manipulation is still a possibility of the future, it can be another way of combating the deadly disease.

Overall, it can be stated that the impact of malaria on the world and human species has been a devastating one, whether it was in the past or the present, carrying with it an enormous global burden and an unimaginable death count. Now being one of the greatest diseases of poverty, having the majority of infection and deaths occurring in impoverished regions of the world has made malaria that much more deadly. Future control and management for malaria will be highly dependent on a series of factors and implementations including antimalarial drugs, insecticides and the continuing development of vaccines, all of which will be of great importance for the parasites eradication. Greater importance and attention along with additional resources for combating malaria have to be implemented in order to help improve prevention, treatment, and control for the disease. Through the use of existing methods and tools it has been shown to be enough for combating/eliminating malaria only if the right conditions are in place including political and regional commitment, proper access to healthcare and financial resources. Without true commitment for prevention malaria will continue to spread at an even higher rate than it already is, the cooperation of the region’s government in which malaria continues to strike and spread is of great importance if a real solution is to be reached.