ECOWAS Program to Eradicate Malaria

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QUESTION
Why can I find no mention on your website of the ECOWAS program to eradicate malaria in their countries?

ANSWER
Thanks for bringing up ECOWAS. Since 2011, ECOWAS leaders have signaled a commitment to eradicating malaria in their region by 2015, and pilot programs are already underway in several countries, including Burkina Faso, Nigeria and Ghana. The program has centered on the use of larvicides for control of mosquito populations, thus reducing transmission. In April 2012, ECOWAS signed an agreement with Cuba in order to revitalize joint efforts to eradicate malaria in both West Africa as well as the Caribbean island. Soon after, Venezuela entered the agreement, pledging $20 million to the cause. These funds
will help support the construction of manufacturing facilities for biolarvicides in Nigeria, Cote d’Ivoire and Ghana, among other things.

In August, the Commissioner of ECOWAS emphasized the need for community engagement in the fight against malaria. A road map for measuring future progress was also drawn up by health advisers from the region; the next high-level ministerial meeting to evaluate the program will take place in West Africa, and will likely include Cuban and Venezuealan partners, in December 2012.

WHO recommends that Larviciding is indicated only for vectors which tend to breed in permanent or semi-permanent water bodies that can be identified and treated, and where the density of the human population to be protected is sufficiently high to justify the treatment with relatively short cycles of all breeding places.

Recurrence of Malaria

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QUESTION

If a person treated for malaria after being infected from a malaria endemic country of West Africa and cured then he travel back to his country which does not known for malaria endemic region of the world. Question is: Is there any chance of re-occurrence even he is not being exposed to malaria spreading mosquito for some time may be year?
Is it true Malaria parasites stays in liver as hibernation for a long period and attack after many months or year?
If so what treatment can prevent it?

Please advise.

ANSWER

There are several different types of malaria which are found in West Africa, and the most common and deadly form, Plasmodium falciparum, is not able to hibernate in the liver. However, two other types of malaria are able to lay dormant in the liver – these two kinds are called Plasmodium vivax and P. ovale. Both are not nearly as common as P. falciparum in West Africa, though P. ovale has been reported at prevalences of over 10% in some areas, which is double its usual prevalence elsewhere in the world. Weeks, months or even years after an initial infection with P. vivax or P. ovale, the patient may experience what is known as a relapse, which is when the dormant liver forms become active again and re-invade the blood stream, causing a renewal of malaria symptoms. These relapses can be treated with normal anti-malarial drugs (even chloroquine, in many cases), but a different drug is required to kill the dormant liver forms and prevent future relapse. This drug is called primaquine, and may not be suitable for people with certain types of G6DP deficiencies, so you should talk to your doctor about having a test for this condition before taking primaquine.

Malaria in Summer

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QUESTION

Does malaria only occur during summer season?

ANSWER

That depends on where you are. The transmission of malaria depends on the presence of the mosquitoes which are required to transmit the disease (they do this when they bite you).

Many kinds of mosquito transmit malaria, though all are of the genus Anopheles. These different species have different climatic requirements, but all lay their eggs in pools of stagnant water, and the larve likewise live in this stagnant water until they develop into adults. As such, malaria is only transmitted when there are suitable pools of standing, stagnant water available for mosquitoes to breed, and also when the temperature is suitable for mosquito development (optimum temperature for mosquitoes is 25-27 degrees C—the malaria parasite develops most rapidly around this temperature as well, though can survive in temperatures about ten degrees cooler as well).

In some regions of the world, this combination of conditions is only met in the summer time, which means that malaria transmission only occurs during this season. In other parts of the world, such as coastal West Africa, conditions are suitable for mosquito breeding and malaria development all year round, which means that malaria transmission occurs throughout the year.

Malaria Deaths in the Tropics

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QUESTION

What’s the difference of malaria deaths between the subtropical and tropical regions and all the other regions?

ANSWER

I am assuming you are asking about the distribution of deaths caused by malaria between the tropics/sub-tropics and the rest of the world.

95% percent of all fatal malaria cases occur in sub-Saharan Africa, which lies entirely in the sub-tropics and tropics. Additionally, most of the deaths occur in Central, West and Eastern Africa (North Africa and South Africa have more advanced malaria prevention and control initiatives to the rest of the continent, and transmission is also less severe), and the other 5% of malaria deaths are mostly found in India and south-east Asia, so you could say that virtually all deaths due to malaria occur in tropical regions alone.

Indeed, there is almost no malaria in non-tropical or sub-tropical regions; the few cases each year in North America and Europe are usually due to imported cases from people who have traveled to tropical or sub-tropical regions.

Dietary Values in West Africa

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QUESTION

In many West African countries where malaria attacks the general population of the people what is their dietary intake like? What are their foods or nutritional values?

ANSWER

In most West African countries, the diet is dominated by starchy tubers or grains, such as cassava, rice, sorghum and millet. This base foodstuff is often served alongside a vegetable or meat-based stew or soup, often thickened with leafy greens or vegetables such as okra. Meat has gained in popularity in recent years, and there has also been a shift from the use of traditional oils (palm oil near the coast and shea nut oil further inland) to processed and hydrogenated vegetable oils.

While the traditional diet is fairly balanced, the emphasis on high amounts of starch can lead to mild malnourishment (particularly through lack of protein) and micronutrient deficiencies. Increasing the proportion of meats and oils in the diet, as is becoming more common, tends to reverse malnutrition into obesity, while not solving the micronutrient deficiencies.

Having said all that, there is little evidence that diet can specifically protect against malaria infection, although good overall health, which can be assisted by a healthy, balanced diet, may provide some protection against progression of the disease and the ability to fight the infection.