Malaria in Limpopo, South Africa

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QUESTION

In which year did malaria spread in Limpopo?

ANSWER

Malaria has likely been in the southern part of Africa for many hundreds, if not thousands, of years. In recent times, control initiatives have been in place in areas of malaria transmission in South Africa since 1945, reducing the incidence of malaria in many places. Other than that, this paper, freely accessible via the Malaria Journal, reports on the incidence, number of cases and number of deaths reported as caused by malaria between 1998 and 2007: Gerritsen et al., 2008. In addition, this site, by the South African government in Limpopo, contains more information about malaria in the area: Limpopo Malaria Control Program.

Malaria Pills Taken with Other Drugs

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QUESTION

Can malaria pills be taken with other vaccines or medications?

ANSWER

Malaria pills can be taken with most other medications, though this may vary with the type of prophylaxis (medication to prevent malaria) that you take, and there may be some specific combinations which are not recommended, so be sure to consult with a doctor about specific drug interactions. For example, Malarone (atovaquone-proguanil) is known to interact with anticoagulant drugs such as warfarin and aspirin, though depending on the dose it may be possible to take both, as long as the patient is carefully monitored.

If you are planning to travel to a malarial area, you will likely need to get a prescription before being able to get prophylaxis, so you should take that opportunity to talk to the nurse or physician about your specific medications and whether they will interact.

Malaria Statistics 2008-2012

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QUESTION

What are the malaria statistics for 2008-2012?

ANSWER

Without more information, I am assuming you would like statistics on malaria cases and deaths for 2008-2012. The best data on malaria comes from the World Health Organization, which retrospectively publishes its best estimated for malaria in its annual World Malaria Reports. Each report publishes the figures from the previous year, and the 2012 report has not yet been published, so at this point the WHO can only provide data for 2008-2010. It is also worth mentioning that as more information is collected, past estimates can sometimes be revised, but here I will present the figures from each annual report itself, rather than longer retrospective estimates.

In 2008, the number of cases was estimated at 243 million, with 863,000 deaths. In 2009, the report did not explicitly summarize the number of cases, but reported that deaths were down to approximately 781,000. In 2010, the number of cases and deaths both dropped yet further, to an estimated 216 million cases and 655,000 deaths. Despite these gains, the aim is to work towards a world with no malaria deaths at all by the year 2015, so much control work remains to be done.

First Cases of Malaria

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QUESTION

What is the first infected person with Plasmodium?

ANSWER

Plasmodium, the single-celled parasite which causes malaria, has been infecting humans since ancient times. In fact, the first written reference to its symptoms dates back almost 5000 years, to an ancient Chinese manuscript! It was also known from the writings of other ancient peoples, such as the Greeks, Romans and Egyptians; when Europeans arrived in the Americas, they found that local tribes had long recognised the dangers of malaria, and already had natural remedies for fever, including the bark of the cinchona tree, which was later used to make quinine (a moden anti-malarial). As such, it is impossible to say now who the first person infected with Plasmodium was, but it definitely occurred many thousands of years ago.

However, it was only until the late 19th century that people understood that Plasmodium parasites caused malaria, and knew how to observe the infection in the patient’s blood. This was done was Charles Louis Alphonse Laveran, a French physician working in Algeria. As such, you could argue that the first person known to have Plasmodium was the patient he observed the parasite within, when he first described Plasmodium. Unfortunately, the patient had died of the disease; Laveran examined the blood after the patient had perished. I am not sure the patient’s name was recorded.

Malaria Infectious?

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QUESTION

Is malaria infectious?

ANSWER

Yes, malaria is considered an infectious disease, though it is very rarely transmitted directly between people, and virtually all of the time must be transmitted via the bite of a mosquito (of the genus Anopheles).

Because part of the life cycle of malaria occurs in red blood cells in the human host, if sufficient amounts of blood are shared between people, for example during a blood transfusion, malaria can also pass between them this way, though screening measures reduce the likelihood of this occurring. Similarly, an earlier part of the life cycle occurs in the liver, so transplant of this organ can also result in transmission.

Finally, malaria is able to pass through the placenta, and so can be transmitted from a mother to her unborn child in this way, or also via blood during childbirth. When a baby contracts malaria from each mother, either via the placenta or during childbirth, it is known as “congenital” malaria.

Life Cycle of Malaria

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QUESTION

Why does the malaria parasite first enter the liver?

ANSWER

The malaria parasite enters the liver in order to transform from a sporozoite (which can infect liver cells) to a merozoite, which is capable of infecting red blood cells. Both stages also include a proliferation step, but in the blood, the merozoites are also able to differentiate into gametocytes, which are then taken back up by a mosquito during a blood meal, allowing the malaria parasite to continue its life cycle. If the red blood cell stage were first, followed by the liver, then it would be much harder for the gametocytes to be able to reach a new mosquito host, unless they were to enter the blood a third time.

The blood is also a difficult place for a parasite to survive, since it is the highway of the immune system, whereas the parasite is less easily destroyed when it is hiding out in the hepatocyte cells in the liver. It is also important to note that Plasmodium has a long evolutionary history, and may in some parts of its life cycle be constrained by physiological or life history characteristics of its evolutionary forebears, which may also contribute to our perception of the life cycle as being very complex!

Malaria Symptoms Flash Back

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QUESTION

I got cerebral malaria in Uganda in 1988. Upon returning to the US I was part of an on-going study through the CDC for a couple years. During that time I had recurrence of what appeared to be an 8-10 hour relapse of the severe body aches, disorientation, fever, chills etc. The tropical doctor that was following me informed me that with something as severe as cerebral malaria the brain can record the experience and periodically and randomly play it back kind of like an LSD flashback. I was tested on multiple occasions and the parasite was dead. This has happened to me every several years since 1988.

I had a recurrence of these malaria-like symptoms last night and this morning and by 10 am I felt fine. I looked online but could not find anything relating to this information of the brain replaying the symptoms. Can you let me know if this is common or true?

Thank you in advance.

ANSWER

Hi, that is a very interesting story! I personally have not heard of other cases where a patient experienced regular “flashbacks” and I have consluted one of our medical advisers, and he has not personally heard of other cases of malaria “flashbacks” either.

It might be worth checking up directly with the CDC to see if any other patients they followed experienced similar after effects.

Malaria Parasite

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QUESTION

1.classificaton
2.structure and size
3.life cycle
4.host range
5.effect on host
6.diagnosis of diseases(symptoms)
7.prevalence(statistics)of malaria cases in limpopo as from 2008-2011.
8.treatment and prevention (tradutional and modern methods) of the duseases
9.what socio-economic and environmental conditions contribute to the disease?

ANSWER

I have answered all of the above questions separately via your other recent posts to this forum – please search, either through scrolling through recent responses or using the search bar at the top of the page. Some of the questions, such as queries regarding diagnosis and symptoms, can be found under “Malaria Overview.”

Malaria Explained

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QUESTION

What is malaria?

ANSWER

Malaria is a serious and sometimes fatal disease caused by a parasite, of the genus Plasmodium, that commonly infects a certain type of mosquito (of the genus Anopheles) which feeds on humans. People who get malaria are typically very sick with high fevers, shaking chills, and flu-like illness. Four kinds of malaria parasites can infect humans: Plasmodium falciparum, P. vivax, P. ovale, and P. malariae. Infection with P. falciparum, if not promptly treated, may lead to death. Although malaria can be a deadly disease, illness and death from malaria can usually be prevented.