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Monday, April 25th is World Malaria Day.
Malaria is mosquito-borne infectious disease caused by a parasite – Plasmodium – and is common in much of the world including Sub-Saharan Africa, Asia and the Americas.
Plasmodium falciparum in human blood – credit wikipedia
There are four microscopic protozoan parasites in the genus Plasmodium (P. vivax, P. falciparum, P. malariae and P. ovale) that cause malaria in humans around the world. Of these Plasmodium falciparum is generally the most serious.
The parasites multiply in the liver and infect red blood cells, resulting in recurrent fevers and headaches - and in severe cases - coma and death.
Malaria is an extremely serious problem in Africa, where 1 in 5 childhood deaths is due to the disease. According to the WHO’s 10 Facts on Malaria:
An African child has on average between 1.6 and 5.4 episodes of malaria fever each year. And every 30 seconds a child dies from malaria.
The World Health Organization describes tomorrow’s World Malaria Day this way:
World Malaria Day
25 April 2011
In 2009, about 3.3 billion people - half of the world's population - were at risk of malaria. Every year, this leads to about 250 million malaria cases and nearly 800 thousand deaths. People living in the poorest countries are the most vulnerable.
World Malaria Day - which was instituted by the World Health Assembly at its 60th session in May 2007 - is a day for recognizing the global effort to provide effective control of malaria. It is an opportunity:
- for countries in the affected regions to learn from each other's experiences and support each other's efforts;
- for new donors to join a global partnership against malaria;
- for research and academic institutions to flag their scientific advances to both experts and general public; and
- for international partners, companies and foundations to showcase their efforts and reflect on how to scale up what has worked.
Related links
While there are medicines available to combat the disease, over time the parasites have developed resistance to many of the older drugs.
Resistance of Plasmodium falciparum to choloroquine, the cheapest and the most used drug is spreading in almost all the endemic countries.
Resistance to the combination of sulfadoxine-pyrimethamine which was already present in South America and in South-East Asia is now emerging in East Africa.
And since about 2007, evidence of resistance to a newer drug regimen known as ACT (Artemisinin Combination Therapy), has been showing up on the Cambodian-Thai border.
Most recently, the same resistance has been observed in Myanmar, as we learn from this IRIN feature article.
MYANMAR: Anti-malarial drug resistance "hotspots" identified
Photo: Wikipedia
Malaria is a leading cause of death in Myanmar
BANGKOK, 19 April 2011 (IRIN) - Health experts had barely finished one project to contain anti-malarial drug resistance along the Thai-Cambodia border when their attention was drawn to Myanmar, where early warning signs suggest a waning influence of the anti-malarial drug Artemisinin.
Although a far greater problem in the developing world, the CDC’s latest MMWR provides us with a surveillance report on Malaria in the United States for 2009.
Here is a link and an excerpt:
Malaria Surveillance --- United States, 2009
Surveillance Summaries
April 22, 2011 / 60(SS03);1-15
CDC received reports of 1,484 cases of malaria, including two transfusion-related cases, three possible congenital cases, one transplant case and four fatal cases, with an onset of symptoms in 2009 among persons in the United States.
This number represents an increase of 14% from the 1,298 cases reported for 2008. Plasmodium falciparum, P. vivax, P. malariae, and P. ovale were identified in 46%, 11%, 2%, and 2% of cases, respectively. Thirteen patients were infected by two or more species. The infecting species was unreported or undetermined in 38% of cases.
Among the 1,484 cases 1,478 were classified as imported.
Malaria, like Dengue and Chikungunya, are increasingly becoming concerns in the developed world, including the United States and parts of Europe.
While relatively uncommon, locally acquired cases of Malaria do occur in the United States. Late last year we saw a suspected case in Jacksonville Florida (see Florida: Locally Acquired Malaria Case Suspected).
In 2006, the CDC issued a guide for the investigation of Malaria in the United States, that included the following data on cases between 1957 and 2003.
September 8, 2006 / 55(RR13);1-9
Locally Acquired Mosquito-Transmitted Malaria: A Guide for Investigations in the United States
EXCERPT
In the United States, approximately 1,000--1,500 cases of malaria are reported annually to CDC (3). Nearly all of the cases diagnosed in the United States are imported from regions of the world where malaria is endemic. However, a limited number of cases also are acquired through local mosquito borne transmission.
From 1957, when the Malaria Branch started conducting malaria surveillance, to 2003, a total of 63 domestic outbreaks have occurred, constituting 156 cases (annual range: 1--32) that resulted from locally acquired mosquitoborne transmission (Figure 1) (4--11).
Of the 63 outbreaks, the highest number of cases occurred in California (17 [27%]) (Figure 2). Outbreaks also have occurred in 23 states. Since approximately 1991, a trend has developed in which outbreaks have occurred in more populated areas (e.g., urban and suburban areas). P. vivax has been the predominant species involved (47 [74.6%] of 63), followed by P. falciparum (seven [11.1%] of 47), and P. malariae (five [10.6%] of 47) (Figure 3).
To finish up our preview of World Malaria Day we have a CDC Grand Rounds video from November of 2010.
Malaria Eradication: Back to the Future
Tune in to Malaria Eradication: Back to the Future, in CDC’s Public Health Grand Rounds monthly series, presented November 18, 2010.
You’ll hear four current and former CDC malaria experts discuss review the history of the malaria eradication campaign (1950s-70s), discuss current control successes and challenges, and explore strategies to eliminate, and eventually eradicate, this deadly disease, which caused approximately 860,000 deaths in 2008.
Watch: Malaria Eradication: Back to the Future [CDC | YouTube]
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