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.