Where did malaria start in Africa?

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QUESTION

Where did malaria start in Africa?

ANSWER

Malaria has been present in Africa for tens of thousands of years; given this ancient history, it is very difficult to know exactly where it first entered the continent. Also, there are several different types of malaria in Africa, which have likely had different histories, and malaria researchers continually unearth new evidence regarding the origins of these different species.

For example, it has long been thought that Plasmodium falciparum, the most deadly form of malaria, emerged somewhere in the western Congo Basin in Central Africa. Originally, it was thought to have crossed over into humans from a closely related species found in chimpanzees, but recent research, published only in 2010, has suggested that a new species, found in gorillas, is actually the closer relative.

Plasmodium vivax, the most geographically widespread species of malaria that infects humans, has less clear origins. Many of its closely related species occur in south-east Asia, which leads some researchers to suggest this is where it emerged, passing into Africa as humans and their livestock moved across Asia towards the Middle East and North Africa, or possibly via  migration through Madagascar. However, other researchers argue that the high prevalence of certain genetic mutations which protect against Plasmodium vivax malaria found in populations in Africa and of African descent, and particularly West Africa, is evidence that P. vivax actually originated on this continent.

When was malaria discovered?

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QUESTION
When did people first discover about malaria?

ANSWER
Humans have known about malaria as a disease for thousands of years. The earliest written record of malaria is from ancient China, 2700 BCE. The ancient Romans and Greeks also described the symptoms of malaria, though none of these ancient people knew the true cause or had identified specifically how it was transmitted. This was first achieved in the 19th century, first in 1880 by Charles Louis Alphonse Laveran, who observed the parasites that cause malaria in the blood of a patient. A few years later, in 1897/1898, Ronald Ross discovered that the parasites were transmitted between hosts via mosquitoes, thus laying the foundations for future decades of malaria control efforts.

How did it get the name “malaria”?

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QUESTION

How did malaria get its name?

ANSWER

The word “malaria” comes from Italian, “mala aria” which literally translates to “bad air”. This came from the ancient association, traced back as far as the ancient Greeks and Romans, that the disease was associated with swampy, marshy areas where the air smelled bad.

The mechanism of transmission was not known back then, nor did they know anything about infectious disease agents like bacteria, viruses or the single-celled protozoa like what causes malaria. So they believed it was the air itself that caused the infection, hence giving malaria its name. The protozoan which causes malaria was not discovered until 1880 when Charles Louis Alphonse Laveran observed the parasites in a patient; it was a few years later, in 1897/1898, that Ronald Ross discovered that mosquitoes transmitted malaria between human hosts. He won a Nobel Prize for this discovery in 1902.

When was malaria first found in humans?

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QUESTION:

When was the first case of malaria in humans discovered? What did the name malaria originate from?

ANSWER:

Malaria has been known to humans for thousands of years; its earliest record is from around 2700 BCE in an ancient Chinese medical text. The ancient Greeks, Egyptians and Indians also recorded cases of malaria and described its symptoms. However, the parasite that causes malaria was first observed in a suffering patient in 1880; in 1897 mosquitoes were discovered to be the agents transmitting the parasite, finally allowing doctors to understand the true nature of the disease. The word “malaria” comes from “mala aria”, Italian for “bad air”, hinting at the long-held association between malaria and foul marshy regions with bad smelling air, which dates back as far as the ancient Romans. Indeed, the mosquitoes that spread malaria breed in stagnant water, so the Romans weren’t too far off!

In which country did malaria start?

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QUESTION:

In which country did malaria start?

ANSWER:

That’s an interesting question! In terms of the evolution of the disease, the different types of malaria probably evolved in different places; it is hypothesised for example, that P. falciparum evolved from a related strain of malaria that is found in gorillas in central Africa, so the human form also probably originates from that area. Although an exact date for the origin of P. falciparum is still under debate, it was probably sometime around 10,000 years ago,  long before modern countries existed in the region!

As for when malaria was first recorded in human populations, it was known in ancient China, as long ago as 2700 BCE, when the ancient Chinese medical text, Nei Ching, was written. Two and a half thousand years later, in around 200 BCE, there are descriptions of the use of Artemisia annua for the treatment of malarial-type fevers; extracts from this plant, known as artemisinins, are still used for the treatment of malaria today.

Malaria was also known from Europe by the 4th century BCE when it was described by ancient Greek writers. The Romans too were aware of malaria and the risks it posed; they even associated the disease with stagnant water (required by mosquitoes to breed, though it is unclear whether they actively understood the association between mosquito bites and the fevers), which led to extensive public drainage works in order to eliminate bodies of standing water.

Given the lack of written histories, it is more difficult to determine the earliest understanding of malaria in the Americas. However, when the Spanish arrived in the 15th century, they learned of local remedies that the indigenous populations had for various fevers; one of these natural medicines was the bark of a tree of the genus Chichona. More commonly called quinine, this compound is still used as an anti-malarial in modern times.

Nowadays, vector control measures, efficient health monitoring systems and treatment availability has much reduced and in some cases even eradicated the transmission of malaria from most of the United States, Europe and even large parts of China. The greatest burden of the disease continues to be in the tropical regions of the world, and in particular, in sub-Saharan Africa.

Malaria in Southern United States

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QUESTION:

Why is there not a prevalence of malaria in the southern United States when we are bitten almost daily by the “little beasts?”

ANSWER:

Malaria once was relatively common in the southern United States. Transmission used to be possible due to the favorable climatic conditions for the development both of the mosquito as well as the malaria parasite. Huge advances in the control and treatment of malaria were made directly as a result of increased interest in the disease after the US occupation of Cuba and the building of the Panama Canal in the early years of the 20th century. This vastly reduced the number of cases of the disease, but the final, concerted effort to eradicate malaria came in the 1940s.

This was due to a federal public health program called the National Malaria Eradication Program (NMEP), and as a result of its actions, malaria transmission was halted throughout the United States by 1951. The program was launched in 1947, coordinated by the newly formed Communicable Disease Center (now the Center for Disease Control and Prevention, or CDC) and mostly involved reducing the number of mosquitoes in and around people’s homes. This was done through the wide-spread spraying of DDT—during the years of NMEP, it has been estimated that more than 6.5 million homes were sprayed with the insecticide. Alongside spraying, mosquito breeding habitats were also removed, through wetland drainage, and human monitoring and treatment efforts were stepped up. By 1949, malaria was no longer considered a disease of public health importance, and it was declared eradicated from the United States in 1951.

Having said that, the species of mosquito that transmit malaria still exist in the USA, and particularly in the southern states, which means that there is always a risk of small, localized outbreaks of the disease, particularly during hot and wet seasons.

Climate change may also increase the zones where malaria is at risk of being able to develop within the United States. For this reason, the CDC continually monitors the small number of cases reported each year in the USA (there were about 1500 cases in 2007—all but four of these cases, however, were the result of travelers to malarial areas outside of the USA bringing the disease back with them) to ensure that they are prepared and well-informed should an outbreak arise.

Which doctor first linked Anopheles to cases of malaria?

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QUESTION:

Which doctor first found that Anopheles mosquitoes transmitted malaria?

ANSWER:

The first person to show conclusively that malaria could be transmitted by Anopheles mosquitoes was Ronald Ross (later knighted in 1911 for his services to medicine).

Working in the Presidency General Hospital in Calcutta (Sir Ronald was born in India and joined the Indian Medical Services in 1881 after studying medicine in London), he observed malaria parasites in the salivary glands of mosquitoes that had been fed on infected birds. This was in 1898, and he was awarded the Nobel Prize for Medicine and Physiology in 1902 based on this discovery. A medical board in 1900 later confirmed his findings, and provided recommendations for the control of malaria, some of which were instrumental in limiting the impact of the disease on workers employed to construct the Panama Canal.

The parasite that causes malaria, of the genus Plasmodium, had been identified in 1880 by the French doctor Charles Louis Alphonse Laveran, who had observed the parasites in the red blood cells of infected patients in Algeria.

How Many Deaths Result from Malaria?

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QUESTION:

Can you tell me, how many deaths result from malaria till today?

ANSWER

A lot! I think it is impossible to get an exact number, or even a decent guess – data on malaria deaths even in modern times are estimates at the best of times, and we have no way of knowing how many people were exposed to and/or died of malaria in ancient times.

Current estimates as to the annual number of deaths from malaria vary depending on which source you look at, but most agree that somewhere around 1 million people die every year from being infected with malaria. Of course, that number would have been lower in the past when total population numbers were also lower.

However, I think it would be fair to say that probably hundreds of millions of people have, over the course of history, died from being infected with malaria. More to the point, malaria continues to be a huge public health burden on huge portions of the world’s population, and disproportionately on the world’s poorest people, which makes it a top priority for disease advocacy, research and control initiatives.