How do you get malaria?

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QUESTION:

How do you get malaria?

ANSWER:

Malaria is caused by parasites called Plasmodium, of which different species cause different types of malaria. A person gets malaria when they are bitten by certain female mosquitoes (of the species Anopheles) that carry Plasmodium parasites in their saliva. The mosquitoes themselves pick up the parasite by feeding on the blood of people already infected with malaria.

Once a person has been bitten by an infected mosquito, the parasites are released into their bloodstream. Inside the body, they reproduce and multiply—different types of malaria have different lengths of reproductive cycle and different locations in the body where the life stages reside. It is the process of reproduction and movement through the body that causes the fever, chills and other symptoms that are associated with a malaria infection.

What is malaria?

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QUESTION:

What is malaria?

ANSWER:

Malaria is a disease caused by parasites of the genus Plasmodium. Transmitted by mosquitoes, there are several different kinds of malaria distributed throughout the tropical and sub-tropical regions of the world, causing somewhere between 300-500 million cases of disease each year, and as many as 1 million deaths. In fact, malaria is one of the biggest killers of children under the age of five in sub-Saharan Africa, one of the regions of the world where the burden from malaria is the highest. Malaria is usually an acute disease, manifesting itself with severe fever, chills, headache and often nausea as well. Some types of malaria can have relapsing episodes over a time period of many years.

Having said this, malaria is easily preventable, through avoiding mosquito bites by wearing appropriate clothing and sleeping under insecticide-treated bednets, or through taking preventative medication (called prophylaxis). Malaria is also treatable once symptoms appear, through ingesting safe, effective and relatively cheap drugs. With such control measures at hand, you may ask why malaria is still such a huge problem in our world; the answer is that delivering control strategies and treatment to populations most at risk is difficult, and often countries with high malaria burdens don’t have efficient and effective health systems in place to coordinate control efforts.

International non-governmental organisations such as the World Health Organisation, as well as a multitude of non-profit organisations such as the Malaria Consortium and Malaria No More, work tirelessly to bring malaria control and treatment to the places that need it most, with the aim to eradicate malaria as a disease of public health importance.

 

Is malaria contagious?

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QUESTION:

Is malaria contagious?

ANSWER:

No, malaria isn’t directly contagious from one person to another. It has to be transmitted by the bite of a mosquito, which means that if someone near you has malaria, those mosquitoes that bite him are carrying the disease! So, the best way to avoid getting infected is to make sure neither you nor your brother are bitten by mosquitoes. The best way to prevent biting is by wearing long sleeved shirts and long trousers, especially during dusk, dawn and at night, when mosquitoes are most active. Similarly, you should try to sleep under an insecticide-treated bednet. These have been proven to reduce biting from mosquitoes, and therefore the transmission of malaria.

Causes of malaria

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QUESTION:

What are the causes of malaria?

ANSWER:

Malaria is caused by parasites of the genus Plasmodium. These are single-celled animals known as protozoans (from the Greek ‘protos’ and ‘zoia’ which together mean ‘first animal’) and they are transmitted via mosquitoes that feed on blood; the parasites need both mosquito and human hosts to complete their life cycle (see below a graphic of the complete life cycle, courtesy of CDC). In the process of reproducing, the malaria parasites destroy human red blood cells, which is what causes the clinical symptoms of disease that the patient experiences, such as fever, headaches and nausea.

Malaria life cycle CDC

Generalized malaria life cycle (courtesy of CDC: www.cdc.gov)

There are four main species of Plasmodium that infect humans: P. falciparum, P. vivax, P. malariae and P. ovale. P. falciparum causes the most severe manifestations of the disease and is responsible for the majority of human deaths from malaria. There is a fifth type of malaria, P. knowlesi, which usually infects macaque monkeys but has been known to pass into humans as well.

For more on this, please see Christina Faust’s excellent blog post about her research.

Is malaria caused by a dietary absence?

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QUESTION:

Is malaria caused by the absence of one of the following in diet: bacteria, virus, fungi, protozoa?

ANSWER:

If I understand your question correctly, you are asking if malaria is caused by the absence of a particular organism from a person’s diet—in fact, malaria is caused by a protozoan, but infection is not linked to a person’s diet. Instead, people are infected with the protozoans (small, single-celled organisms—in the case of malaria, they belong to the genus Plasmodium) when a mosquito feeds on the person’s blood. The malaria parasites are present in the mosquito’s saliva gland, and enter the human bloodstream as the mosquito is drinking. When a mosquito feeds on a person already infected with malaria, it picks up malaria parasites in the blood it takes in. This is how malaria is transmitted, in the vast majority of cases.

Malaria in Malaysia

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QUESTION:

Is there malaria in Malaysia?

ANSWER:

Yes, there is malaria in Malaysia, although efficient vector control campaigns, alongside a well-functioning health system which effectively diagnoses and treats malaria cases has vastly reduced the transmission of the disease in peninsular Malaysia at least. Transmission is still a problem in rural, interior areas, and especially in Sabah and Sarawak.

The history of malaria control in Malaysia is actually something of a success story; back in 1961, there were over 240,000 reported cases of malaria across the country; this was reduced to about 40,000 cases by 1980, due to the measures mentioned briefly above, and in 2008, that number had further dropped to only about 7,000 cases a year.

The fatality rate of malaria in Malaysia is also very low, being about 0.09%, or about 50 deaths a year, which is a testament to the effectiveness of national health systems at monitoring for the disease. Having said that, Plasmodium falciparum, the most severe type of malaria, is present in Malaysia—it was this that was responsible for all the reported fatalities in 2008. As such, if you are visiting or living in rural regions of Malaysia, where malaria transmission still is relatively high, it is recommended that you take preventative measures against the disease, such as sleeping under an insecticide-treated bednet, or taking prophylactic (preventative) medicine. This latter measure is usually only worthwhile if you are visiting a malaria area for a relatively short time, as the drugs can be quite expensive.

If you have visited these rural areas, and have symptoms of malaria, such as fever and chills, within two weeks of returning, you should go to the hospital or visit a physician immediately for diagnosis. If it is malaria, the doctor will be able to provide you with the most appropriate medicine for the type of malaria that you have.

What are the strains of malaria?

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QUESTION:

What are the different strains of malaria?

ANSWER:

Malaria is caused by small, single-celled parasites called protozoans, and specifically ones of the genus Plasmodium. There are many, many species of Plasmodium, which infect a wide variety of different species, from lizards and birds to rodents, bats and primates. Of all the species of malaria, four main ones infect humans – these are P. falciparum, P. vivax, P. ovale and P. malariae. A fifth species, P. knowlesi, usually infects macaque monkeys in South East Asia but has been known to cross over to humans. Each of these species causes slightly different manifestations of the disease in humans, and even within the species, there are regional strains and variations. Probably the most distinct internal division within a malaria species is within P. ovale, where two sub-species are currently recognised: P. ovale curtisi and P. ovale wallikeri. These two forms are identical morphologically (that is, in the way they look under the microscope) but can be differentiated genetically.

Malaria in Sub-Saharan Africa

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QUESTION:

I live in the USA and I would like to start a business to fight mosquitoes and malaria: Can you advise me how and where to start?

ANSWER:

I take it from the subject heading of the question that you would like to focus on sub-Saharan Africa—a crucial thing to note at this stage is that malaria is serious disease that affects millions of people throughout Africa (as well as across the rest of the world’s tropical and sub-tropical regions) and as such, I would encourage you to think about ways in which you can help people fight the burden of this illness.

You also should understand that many of the people who are at greatest risk from contracting malaria also happen to live in extreme poverty; an inability to pay for diagnosis or treatment is one of the great problems affecting the sustainability of malaria control initiatives in developing countries. As such, if you plan to start a business aimed at fighting mosquitoes and malaria, you need to think carefully about the model for such an initiative; for example, do you intend to make a profit? Many organisations already work in sub-Saharan Africa as non-profit organisations (NPOs), which use fund-raising or the sale of bednets in order to provide free services elsewhere, and these types of organisations are generally better respected in terms of their motivation to eliminate the burden of malaria in impoverished communities. So, if this sounds like the type of work you would be interested in setting up, I would look at the various other organisations that are already working on the ground in sub-Saharan Africa (Malaria No More, the Malaria Consortium, and non-governmental organisation such as the World Health Organisation and UNICEF, to name a few) and see if you can find a niche where you think you can make a difference to people’s health. To gain experience, you might also consider seeing if any of these organisations accept volunteers or have job positions open, to see what working to fight malaria is really like in practice.

What is malaria, and how can it be cured?

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QUESTION:

What is malaria? How could we cure it?

ANSWER:

Malaria is a disease caused by parasites of the genus Plasmodium. Transmitted by mosquitoes, there are several different kinds of malaria distributed throughout the tropical and sub-tropical regions of the world, causing somewhere between 300-500 million cases of disease each year, and as many as 1 million deaths. In fact, malaria is one of the biggest killers of children under the age of five in sub-Saharan Africa, one of the regions of the world where the burden from malaria is the highest. Malaria is usually an acute disease, manifesting itself with severe fever, chills, headache and often nausea as well. Some types of malaria can have relapsing episodes over a time period of many years.

Having said this, malaria is easily preventable, through avoiding mosquito bites by wearing appropriate clothing and sleeping under insecticide-treated bednets, or through taking preventative medication (called prophylaxis). Malaria is also treatable once symptoms appear, through ingesting safe, effective and relatively cheap drugs. With such control measures at hand, you may ask why malaria is still such a huge problem in our world; the answer is that delivering control strategies and treatment to populations most at risk is difficult, and often countries with high malaria burdens don’t have efficient and effective health systems in place to coordinate control efforts.

International non-governmental organisations such as the World Health Organisation, as well as a multitude of non-profit organisations such as the Malaria Consortium and Malaria No More, work tirelessly to bring malaria control and treatment to the places that need it most, with the aim to eradicate malaria as a disease of public health importance. There are also many research groups around the world that are striving to create new, more effective medications and drugs. For some time now, there has also been work in progress trying to develop a vaccine against malaria; at this point, there has been little applied success, but with further research and efforts, an immunization against Plasmodium may be forthcoming in the future.


Can malaria kill you?

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QUESTION:

Can malaria kill you?

ANSWER:

YES! Malaria, especially of the kind caused by Plasmodium falciparum parasites, can be an extremely severe illness and even deadly. Somewhere between 700,000 and 1 million people die of malaria every year, and the majority of these are children under the age of five years old, which is the age group most susceptible to severe malaria attacks. Pregnant women are also at elevated risk, due to their compromised immune systems. Therefore, preventing malaria in young children and pregnant women is the single most effective way to reduce the number of malaria fatalities; in highly endemic areas, this is usually achieved through the distribution of insecticide-treated bednets, to sleep under at night to reduce mosquito bites, or preventative medication such as intermittent preventive therapy (IPT).

Given the seriousness of malaria, it is prudent to check with a doctor or go to hospital if you live in a malaria endemic area and come down with symptoms of the disease such as high fever, chills and nausea. The majority of malaria cases are easily treated with oral medication, given swift and accurate diagnosis.