Malaria Beliefs

QUESTION

How do beliefs and attitude affect the spread, treatment and prevention of malaria?

ANSWER

Accurate information and knowledge about how malaria is transmitted, diagnosed and treated is crucial to controlling the disease, for the general public living in malarial areas, travelers to these areas and health professionals. For example, many travelers are unaware that their destination is in a malaria transmission zone, so they do not take appropriate preventive precautions. Similarly, many travelers I have met believe that if they have had malaria once, they are immune and cannot get reinfected, so don’t bother protecting themselves from mosquitoes – this is not true, and they are inadvertently putting themselves at great risk.

In terms of endemic areas, the focus is on educating people about day-to-day preventive measures, such as sleeping under long-lasting insecticide treated bednets and indoor residual spraying. Educational campaigns that focus on simple, straightforward ways to prevent malaria are more likely to influence people’s attitudes and lead to better malaria control. Similarly, teaching people to seek accurate diagnosis and then ensuring they have appropriate treatment is an important step.

In some places, people feel they cannot afford to visit a doctor or clinic, or would rather place their trust in a traditional healer or healing herbs; since the most effective medications against malaria are treatments such as artemisinin-based combination therapies, which are available through official health sources such as clinics, believing in traditional medicine can lead to the malaria infection becoming very severe, and even resulting in death. As such, another component to control is making sure that medical services such as clinics are easily accessible even for the poorest people, provide good health care and are affordable.

Prevention of Malaria

QUESTION

What is the prevention of malaria?

ANSWER

Malaria prevention consists of a combination of mosquito avoidance measures and chemoprophylaxis. Although very efficacious, none of the recommended interventions are 100% effective.

Mosquito Avoidance Measures

  • Because of the nocturnal feeding habits of Anopheles mosquitoes, malaria transmission occurs primarily between dusk and dawn.
  • Contact with mosquitoes can be reduced by remaining in well-screened areas, using mosquito bed nets (preferably insecticide-treated nets), using a pyrethroid-containing flying-insect spray in living and sleeping areas during evening and nighttime hours, and wearing clothes that cover most of the body.
  • All travelers should use an effective mosquito repellent.
  • The most effective repellent against a wide range of vectors is DEET (N,N-diethylmetatoluamide), an ingredient in many commercially available insect repellents. The actual concentration of DEET varies widely among repellents. DEET formulations as high as 50% are recommended for both adults and children older than 2 months of age (see the Protection Against Mosquitoes, Ticks, and Other Insects and Arthropods section later in this chapter). DEET should be applied to the exposed parts of the skin when mosquitoes are likely to be present.
  • In addition to using a topical insect repellent, a permethrin-containing product may be applied to bed nets and clothing for additional protection against mosquitoes.

Read the full article about Malaria Prevention.

Can I Catch Malaria from Someone?

QUESTION

My fiancee contracted malaria a few years ago. It was diagnosed as recurring. Could I contract malaria from the infected person, I have had similar symptoms which last a day or two, recurring with regular two week intervals, of which the most concerning are malaise, fever, stiff neck, headaches and severe pains over abdomen spreading into my mid back. What should I do?

ANSWER

Malaria cannot be directly transmitted between two people—it is almost always transmitted by the bite of an infected mosquito, and cannot survive at low temperatures (under about 17 degrees C). In some very rare cases, malaria can be transmitted through organ transplant, blood transfusion and pregnancy, since it infects red blood cells. Given these restrictions, it is close to impossible that you contracted malaria from your fiancee, and you should talk to your doctor about alternative explanations.

Also, if your girlfriend has recurring malaria, she should talk to her doctor about taking primaquine. While not suitable for everyone (namely people with G6DP deficiency should not take it), it can kill the dormant stages of the malaria parasite and prevent recurrence.

Number of Malaria Infections Per Mosquito

QUESTION

How many people get malaria by one mosquito?

ANSWER

That is a very interesting question—the answer is that is varies between regions, and also depends on the type of mosquito. It was often believed that female mosquitoes (which feed on blood—males only feed on nectar) required a single blood meal in order to lay eggs and reproduce, and so would feed approximately once per week, infecting a single host each blood meal. However, recent evidence has shown that in many locations, Anopheles mosquitoes will actually take multiple blood meals on a single night, thus potentially being able to infect several hosts per gonotrophic (reproductive) cycle. Even more interestingly, in some studies it appears that mosquitoes infected with Plasmodium are more likely then uninfected mosquitoes to take multiple blood meals, thus suggesting that the parasite is in some way manipulating the feeding behaviour of the vector mosquito in order to facilitate its own transmission!

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