by Malaria Q&A
QUESTION
Is there any chance of opposing the malarial infection by hormones? If yes,then how is that done?
ANSWER
Malaria incidence is roughly equal between males and females, so it is not believed that sex hormones have any influence of infection rates. However, the progress of infection with respect to hormones has not been extensively studied. It is unlikely that hormonal supplements would have effect in preventing infection.
by Malaria Q&A
QUESTION
How to prevent malaria?
ANSWER
Despite its wide geographic range and potentially severe consequences, there are actually several effective strategies for controlling malaria, many of which have been successful of reducing the burden of the disease, and especially the number of deaths, in various regions.
The first step towards control is prevention. This has largely been achieved through the distribution of long-lasting insecticide treated bednets, which prevent people from being bitten by infected mosquitoes as they sleep at night. While this has drastically reduced the number of cases of malaria in some settings, and particularly in certain high risk groups such as children under five and pregnant women, some worrying new data just was published which suggested that in high transmission zones, bednets may actually exacerbate re-infection rates for older children and adults, and lead to insecticide resistance in mosquitoes. As such, while bednets clearly are still a key prevention strategy, their effect should be closely monitored.
Secondly, there is diagnosis and treatment. These go hand in hand, as they usually require the availability of health services or health professionals. If malaria infections are rapidly and accurately diagnosed, appropriate treatment can be swiftly given, preventing the progression of the disease and allowing the patient to recover. Appropriate administration of medication, as well as adherence to the full course of the drugs, can also help to prevent drug-resistance from emerging.
Finally, there are on-going research initiatives looking to find new ways to tackle malaria. For example, many scientists are involved in the search for a malaria vaccine, which, if safe, effective, and sufficiently cheap, could transform the way we think about fighting malaria. Similarly, due to the unfortunate circumstance of ever-increasing drug-resistance, particularly in Plasmodium falciparum, new types of medication are constantly being tested and trialled. The combination of all these efforts has managed to reduce the mortality of malaria greatly over the past few years; the aim now, espoused by organisations such as Malaria No More, is to get to a point where deaths from malaria are eliminated by the year 2015.
by Malaria Q&A
QUESTION:
What is there I can do to help them?
ANSWER:
Thank you for your concern! Probably the easiest and most direct way you can support the people suffering from malaria infections, especially in the developing world, is by helping to spread awareness about the impact of the disease and how it affects millions of people worldwide.
To help with these campaigns, you can also donate to organisations dedicated to fighting malaria, such as Malaria No More, or the Nothing But Nets campaign.
Finally, if you or people you know are going to be travelling to malarial areas, make sure that you are fully informed of the risks of malaria and take all the preventative actions that you should to make sure you yourself don’t get malaria as well!
by Malaria Q&A
QUESTION:
What name brand medicine should you take if you are traveling to area where malaria is present?
ANSWER:
That depends on a few factors, such as where exactly you are going, whether you have had bad experiences with any malaria preventative drugs (prophylactics) in the past, and how much money you want to spend! Common brand names of malaria prophylactic drugs include Lariam (generic name mefloquine) and Malarone (a combination of atovaquone and proguanil). Doxycycline is also a popular antimalarial, which is often sold under its generic name.
by Malaria Q&A
QUESTION:
As a result of a blood test I have just been informed that at some time I have had malaria. Though I have no idea when this was. I once was ill for 4 days with what I thought was flu and that is the only occasion I can remember. Therefore I have never been treated for malaria. Could you please tell me if there is any chance the disease will come back.
ANSWER:
That will depend on the type of malaria you had. I presume you found out you were infected through a blood test – it is likely a test that looked for antibodies to malaria in your blood. These tests can sometimes differentiate between the different species of malaria, and so it is definitely worth asking the clinic or doctor that performed the test if they can give you this information. Your location, or places where you have travelled in the last 4 years, may also assist in determining which type of malaria you had. Given that you barely registered being sick, I would suspect that you probably didn’t have Plasmodium falciparum, which is usually the most severe kind; it also cannot survive dormant in your system for long periods of time, so if you happened to have this kind, you wouldn’t need to worry about it coming back (though of course you can still be re-infected by all types of malaria, so prevention is still important!).
However, the other three main types of malaria can linger in a patient’s body. P. malariae is the least acute of all the malaria species, and can survive for a long time in the bloodstream, meaning that some people can have the infection for long periods of time without really feeling sick. If the blood test you took looked directly for parasites in your blood, and you tested positive, it is likely you have this kind. Like all uncomplicated cases of malaria, it is easily treatable, and once cured, you won’t have worry about it coming back (again, you do still need to watch out for being bitten by mosquitoes and getting re-infected though!).
The final two types of malaria are P. vivax and P. ovale. These persist in the body in a slightly different way than P. malariae – these have a special life stage which can lie dormant in the liver. Months or even years later, these dormant stages can re-activate and enter the blood stream, causing the patient to feel symptoms again, such as fever and nausea. Therefore, if you find you tested positive for one of these two forms, it is very important to ask your doctor about receiving medication (called primaquine) that will specifically target the liver stages of the parasites, to ensure you don’t get a recurrence of the infection later on.
As I’ve mentioned a couple of times earlier in this response, a key thing to be aware of is that even if you don’t have a recurring form of malaria, or treat it successfully, you will still be susceptible to re-infection if you are bitten by an infected mosquito. As such, if you live in or travel to a region known to have malaria transmission, it is crucial to take steps to prevent infection. For example, sleeping under a long-lasting insecticide treated bednet greatly reduces your risk of being bitten by the mosquitoes that carry malaria; similarly, wearing long-sleeved clothing and insect repellent, especially at night when malaria mosquitoes are most active, is recommended. Finally, medication is available that can be taken to prevent malaria (these are called prophylactics). As they can be expensive and are not recommended to be taken over long periods of time, these tend to be used primarily by people travelling to malarial areas rather than residents. There are several different forms of these prophylactics available commercially; the one to use will depend on several factors, including where you are travelling to.
by Malaria Q&A
QUESTION:
What are reasons for the increasing number of cases of malaria?
ANSWER:
As I recently wrote in answer to another Q&A post, it is difficult to determine whether cases of malaria are indeed increasing or not. For one, a large number of cases are not reported every year, making accurate estimates difficult. Secondly, the world’s population is growing, and it is growing at the greatest rate in Africa, where the majority of malaria cases occur. As such, even if the proportion of people with malaria decreases over time, due to health initiatives such as distributing long-lasting insecticide treated bednets or free treatment, the total number of cases may still rise. Another problem we face in the fight against malaria is climate change: as the world’s patterns of rainfall and temperatures change, new areas become susceptible to malaria transmission, putting more people at risk. However, what is very encouraging is that deaths from malaria seem to be decreasing on a global scale. Malaria No More is an organisation dedicated to eliminating deaths from malaria by the year 2015; more information about their methods and some of their success stories can be found on their website.
by Malaria Q&A
QUESTION:
What does malaria cause?
ANSWER:
Malaria is a disease. It is caused by tiny single-celled parasites called Plasmodium, which are transmitted through the bite of infected Anopheles mosquitoes. There are many symptoms that occur as a result of infection with malaria, namely fever, chills, headaches and nausea, among others. Malaria can be a very serious disease, especially if not treated promptly, and so when spending time in malaria-infection areas (such as many areas of low to moderate elevation in the tropics and sub-tropics) precautions should be taken to avoid mosquito bites and thus infection. If a person finds themselves suffering from some of the above symptoms after being in a malaria transmission region, it is crucially important they get diagnosed straight away; if they do indeed have malaria, then they can be given treatment to facilitate a quick and safe recovery.
by Malaria Q&A
QUESTION:
What are some things that might be done to make the situation better for those most affected with malaria in Africa?
ANSWER:
Currently, the emphasis on decreasing the burden of malaria on those most affected in Africa is based on a combination of prevention, education, research and treatment. In more detail:
Prevention: This is arguably one of the keys to sustainably reducing malaria burdens and even eliminating infections. Central to this goal has been the distribution of long-lasting insecticide treated bednets, which prevent people from being bitten by infected mosquitoes while they sleep at night. Unfortunately, some recent research has just been published which suggests that bednets might be contributing to insecticide resistance in mosquitoes, as well as increased rates of malaria in adults due to decreasing natural immunity. As such, it may be that more research is needed in order to determine the most effective and efficient ways of using bednets to prevent malaria infection, particularly in high-risk groups like young children and pregnant women.
Education: Through education, people living in at-risk areas for malaria transmission can learn about ways to prevent the disease, as well as what to do if they suspect they are infected. Similarly, education is important for travellers visiting malarial areas, so they know the best ways in which to avoid being infected.
Research: Understanding the distribution, factors affecting transmission and the development of new strategies for control and treatment is going to be crucial in the fight against malaria, and particularly in high-burden areas such as Africa. Similarly, scientists are busily looking for new compounds to treat malaria, as well as the ever-elusive malaria vaccine. If such a vaccine could be developed, it would be a huge step forward in the fight against malaria.
Treatment: Hand in hand with treatment comes diagnosis; if a person can have their infection easily, accurately and cheaply diagnosed, then they will be able to access effective treatment more rapidly, thus improving their chances of a swift recovery. As such, countries in Africa are working hard to provide health systems capable of local diagnosis and availability of treatment, so that people don’t have to travel far to have their infections cured.
Taken together, these four strategies are having some success even in the world’s poorest and most malaria-endemic regions, especially in decreasing the number of malaria deaths. Decreasing the overall number of infections will be yet a greater challenge, but one which the world, especially through commitment to the Millenium Development Goals, is dedicated to overcoming.
by Malaria Q&A
QUESTION:
Hi, my husband is an expat working in Mozambique for the past 5 years. He has been diagnosed with malaria 9 times, what are the long term effects of this and is he just unlucky or do others also get infected often? thanks.
ANSWER:
If the proper precautions are not taken, then it is very easy to get infected with malaria multiple times; I have one Ugandan colleague who claims he gets sick at least once a year from malaria, usually sometime in the rainy season. However, there are means to protect oneself from regular infection, and it might be that your husband could be more vigilant about such methods of prevention. For example, he should make sure he sleeps under a long-lasting insecticide treated bednet, which drastically reduced the risk of being bitten by mosquitoes at night. Similarly, he should try to wear long trousers and long-sleeved shirts, preferably impregnated with a substance called permethrin (an insecticide which prevents mosquitoes from biting through clothing – it can be purchased at most camping stores and sprayed directly onto clothing only, not onto skin), especially at dawn, dusk and at night, when malaria-carrying mosquitoes are most active. When mosquito numbers are high, he could also use insecticide that contains DEET on any exposed skin as a further precaution against bites.
The good news is that if his previous bouts of malaria have been uncomplicated, and diagnosed and treated quickly, there should be no long term effects of having had the infection.
by Malaria Q&A
QUESTION:
What is malaria? How can it be controlled?
ANSWER:
Malaria is a disease caused by a single-celled parasite called Plasmodium. There are four species that regularly infect humans: P. falciparum (which causes the most severe form of the disease, and is responsible for 90% of the annual 700,000 fatalities caused by malaria, mainly in Africa), P. vivax, P. ovale and P. malariae. A fifth species, P. knowlesi, has recently also been reported in a small number of cases in south-east Asia, where prevalence appears to be increasing.
Despite it’s wide geographic range and potentially severe consequences, there are actually several effective strategies for controlling malaria, many of which have been successful of reducing the burden of the disease, and especially the number of deaths, in various regions. The first step towards control is prevention. This has largely been achieved through the distribution of long-lasting insecticide treated bednets, which prevent people from being bitten by infected mosquitoes as they sleep at night. While this has drastically reduced the number of cases of malaria in some settings, and particularly in certain high risk groups such as children under five and pregnant women, some worrying new data just was published which suggested that in high transmission zones, bednets may actually exacernate re-infection rates for older children and adults, and lead to insecticide resistance in mosquitoes. As such, while bednets clearly are still a key prevention strategy, their effect should be closely monitored.
Secondly, there is diagnosis and treatment. These go hand in hand, as they usually require the availability of health services or health professionals. If malaria infections are rapidly and accurately diagnosed, appropriate treatment can be swiftly given, preventing the progression of the disease and allowing the patient to recover. Appropriate administration of medication, as well as adherence to the full course of the drugs, can also help to prevent drug-resistance from emerging.
Finally, there are on-going research initiatives looking to find new ways to tackle malaria. For example, many scientists are involved in the search for a malaria vaccine, which, if safe, effective, and sufficiently cheap, could transform the way we think about fighting malaria. Similarly, due to the unfortunate circumstance of ever-increasing drug-resistance, particularly in Plasmodium falciparum, new types of medication are constantly being tested and trialled. The combination of all these efforts has managed to reduce the mortality of malaria greatly over the past few years; the aim now, espoused by organisations such as Malaria No More, is to get to a point where deaths from malaria are eliminated by the year 2015.