Where Does Malaria Occur?

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QUESTION

Where does malaria occur?

ANSWER

Malaria has at some stage or another occurred on every continent of the world except Antarctica. Currently, cases of human malaria are mainly found in Central and South America, parts of the Caribbean, sub-Saharan Africa, parts of the Middle East, south Asia, south-east Asia, and the Pacific Islands of Oceania. Control efforts, mainly consisting of reducing populations of vector mosquitoes, has eliminated transmission from North America, most of Europe, most of North Africa and parts of the Middle east and Asia. Currently, the vast majority of malaria mortalities occur in sub-Saharan Africa, and mainly in children under the age of five.

Malaria Deaths

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QUESTION 

what percent of people die each year from Malaria?

ANSWER

There are an estimated 216 million cases of malaria each year around the world, and about 655,000 deaths due to malaria. This means that overall mortality from malaria is actually very low, around 0.3%, of those who get infected. However, the majority of the people who die from malaria each year are children, and in sub-Saharan Africa.

In terms of the proportion of global deaths that are caused by malaria each year, the percentage is also very small—only about 1%. But that is still a lot compared to most other diseases, and malaria is still one of the leading causes of death of children under 5 in many parts of the tropics, and especially in Africa.

Malaria and Employees

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QUESTION

I have a domestic employee that has malaria. I also have a 1 year old baby at home. Is it safe to keep her in employ or should I grant her leave until she is fully recovered?

ANSWER

Malaria cannot be transmitted between people directly. It is transmitted via the bite of an infected mosquito. As such, the only way your baby could get malaria from your employee is if a mosquito bit the employee, then directly bit your infant. Therefore, the best way to prevent transmission of malaria in this case is to make sure both your employee and your child sleep under long-lasting insecticide treated bednets.

You should also make sure your windows and doors are screened, to prevent the entry of mosquitoes that could carry malaria. These mosquitoes feed mainly at night and in the evenings and early mornings, so during these times, you should take extra precautions against getting bitten, such as wearing long sleeved clothing and covering exposed skin in insect repellent. If you have air conditioning, having this on at night can also prevent mosquitoes from entering rooms. You should also make sure your employee gets appropriate treatment for malaria and takes the full course of medication.

Malaria in Hong Kong and China

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QUESTION

Is malaria a risk in Hong Kong and Southern China?

ANSWER

There is no reported malaria transmission in Hong Kong, nor in the provinces directly bordering it in southern China. However, there is some risk of malaria in other parts of southern and central China, notably in the provinces of Anhui, Guizhou, Hainan, Henan, Hubei, and Yunnan, though rare cases may also be observed in other rural parts of the country between December and May below <1,500 m (4,921 ft).

Organizations Against Malaria

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QUESTION

What is a good organization that helps stop malaria?

ANSWER

There are many organizations that work very hard to control malaria. The most well known are those that design policies and implement projects to control malaria on the ground, in places where the disease is most deadly. These include multilateral international organizations such as UNICEF and the World Health Organization (as well as its regional counterparts, such as the Pan-American Health Organization, PAHO), country-led aid organizations such as DIfD in the UK and USAID in the US (the President’s Malaria Initiative, PMI, is largely implemented via USAID) as well as non-governmental organizations which seek to improve the lives of people in developing countries, such as Save the Children, Malaria No More and many other such groups.

Some of these groups have also joined forces to create multi-faceted organizations and programmes dedicated to controlling malaria, such as the Roll Back Malaria consortium and the Global Fund to fight AIDS, TB and Malaria, which provides millions of dollars of funding to projects throughout the world.

Secondly, there is also an aspect to malaria control which is not so easily seen on the ground, and that is the vast numbers of researchers who are dedicated to finding new drugs to treat malaria, new methods for control and new insecticides to prevent transmission from mosquitoes, among many other examples. These researchers are found in universities and research institutes all over the world, including many in sub-Saharan Africa, India and other places where the burden of malaria is very high.

On our website, you can find some personal accounts of scientists, working for the global pharmaceutical company AstraZeneca, who are doing drug discovery research in Bangalore, India. There are also blog posts from scientists at Princeton looking at transmission of malaria between monkeys and humans in south-east Asia, and information about cutting edge research at the Global Health Group at the University of California, San Francisco, whose members conduct work on a variety of aspects of malaria biology and control initiatives.

Severe Head Pain with Malaria

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QUESTION

Can severe head pain be a symptom of mistreated malaria? My son just returned from an 8 month trip to Ghana. He had malaria 3 times and typhoid 1 time. He is now dealing with a severe head pain in his frontal lobe.

He took doxycycline every day and when he got really sick, he took Coartem. He was finally sent home because they couldn’t figure out why he has such severe head pains. Where do we go from here? He has an MRI scheduled and an appointment with an Infectious Disease Doctor. I am afraid they will not know what to do to help him. I am seeking more advice. Hopeful…CT

ANSWER

Severe head pain is not associated with mistreated malaria, nor indeed is considered a possible lasting effect of malaria infection. You are doing the right thing by going to see a doctor, including one who is an infectious disease specialist—I hope they also have experience with tropical medicine, since in the US and Europe, many very well-trained doctors are still not very familiar with the types of infections which are more commonly observed in the tropics.

Your son was right to take Coartem when he had malaria, but do you know whether he went to a clinic for diagnosis first? The symptoms of malaria are very general, such as fever, chills, nausea and aches, and many people in malarial areas (particularly visitors) often assume they have malaria when in fact their symptoms could be caused by a number of other things.

Secondly, doxycycline is considered a very effective preventive medication against malaria, but only if taken properly. Since doxycycline can cause mild stomach upset, many people take it with milk, which can lessen these symptoms; however, the calcium in the milk can bind to the drug, preventing successful absorption and reducing its efficacy as a malaria preventive.

If your son had a diet high in diary products or took antacids while in Ghana, this could explain why he suffered several malarial episodes. Alternatively, if he took the drug regularly and correctly, and particularly if he did not seek diagnosis via blood test from a clinic, that may be an indication that he wasn’t suffering from malaria at all, and other causes should be explored.

Finally, one of the very well-described side effects of doxycycline is its tendency to cause people to become very sun sensitive. While this usually manifests itself in skin sensitivity, it could also be that your son has become more visually sensitive to light, which in itself could lead to severe headaches. I hope he feels better soon!

Other Causes of Malaria

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QUESTION

Apart from mosquitoe bites, is there any other thing that can cause malaria or if not from mosquitoes, is there any other way someone can get malaria?

ANSWER

Since the malaria parasites reside and reproduce in the blood, in some cases it is possible to transmit malaria from person to person through transfer of a large volume of blood, for example during a blood transfusion.

Some life stages of the parasite are also present in the liver, so cases of malaria transmission via organ donation (particularly of the liver) have also been noted. Finally, it is possible for a mother to transmit malaria to her unborn child via the placenta, or sometimes during childbirth, via the blood. The observation of malaria in newborn babies, who have not been bitten by mosquitoes, is known as congenital malaria. Despite the above possibilities, the vast majority of malaria transmission occurs via the bite of infected mosquitoes, so it is very important to protect yourself from these insects when in malarial areas.

Malaria Recurrence

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QUESTION

I had malaria 5 months back it has again reoccurred. this time there has been increase in the size of the spleen. As of now it is being treated but I fear of getting it again. Is it true the malaria which i am down with reoccurs every 6- 8 months ??? Local people call it as registered malaria.. .

ANSWER

There certainly are types of malaria that can reoccur relatively regularly, at various intervals. This malaria is caused by one of two species, either Plasmodium vivax or Plasmodium ovale.

With both, it is important to get it diagnosed via a blood test with a doctor before getting treated again, to make sure it is indeed a relapse of the same malaria, and not a new infection with a different kind, or indeed some other disease (the symptoms of malaria can often be confused with other infections).

There is also medication that can be taken to prevent future relapses and re-occurrences—it is called primaquine, so you should talk to your doctor about the possibility of taking this medication. Please note it is not suitable for people who have G6DP deficiency, so you should be tested for that before taking it.

Long and Short Term Effects of Malaria

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QUESTION

What are the long term and short term effects of malaria in brief please?

ANSWER

The symptoms of malaria as an acute infection vary somewhat depending on the type of malaria, but usual signs include high fever (often in a cyclical pattern, with fever one day, then no fever for one or two days, then a recurrence of fever), chills, body aches and nausea.

For Plasmodium falciparum, the most deadly form of malaria, the infection can progress rapidly if left untreated, with organ failure, impaired consciousness, coma and even death occurring as quickly as a few days after the onset of symptoms.

If the patient is able to survive the infection, or gets treatment in time, there are usually no long term affects of malaria infection. Some people who have suffered severe cerebral malaria (from P. falciparum) may experience some longer term neurological effects. Other types of malaria, such as P. ovale and P. vivax, can form dormant life stages which hide in the liver for weeks, months or even years, leading to relapse at a later date. However, apart from these recurrences, there are also no long term effects of infection with these types of malaria.

Malaria Vaccine

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QUESTION

What is the shot you get to prevent malaria?

ANSWER

There is currently no shot available to prevent malaria. The most promising vaccine candidate, called RTS,S and being developed by GlaxoSmithKline, is currently undergoing Phase III trials in children in Africa.

Preliminary results have indicated it may prevent up to 50% of malaria cases, though this varies by age group and long term data are not yet available. The full results of the study will be published in 2014.