The malaria story starts with a painless bite on any exposed part of the skin that mostly occurs between dusk to dawn as she plunges her mouthpiece into the skin. The only inking you have of her presence is the annoying sound when she hovers around your ears looking for a suitable point of contact. The mosquito has long, filament-thin legs and dappled wings; she's of the genus Anopheles which is fatal, the only insect capable vector of the human malaria parasite. The female anopheles depends on protein rich hemoglobin to nourish her eggs; she drills the outer skin, through layer of fat then into the network of capillaries to drink blood with the capacity to drink up to 2.5 times her body weight. They carry the blood in the salivary gland and enter another individual through worm like structures called plasmodium. The parasites remain in the blood stream for a few minutes then flow through the circulatory system to the liver. Inside the liver cells the malaria parasite Plasmodium falciparum eats and multiply then eventually burst to be released into the blood stream that is when the feverish condition and symptoms become apparent. Mosquitoes have an incubation period of 9-14days and usually transmit the malaria parasite when they feed on an infected human. Typically, symptoms may include Fever, headache, sweats & chills, pain in the back & limbs, exhaustion, coughing, diarrhea, nausea & vomiting etc.
Today 25th April, marks the commemoration of “Malaria Day” globally and the theme for the 2013 celebration is “Invest in the Future…….defeat malaria”. It is a call for all to take part in a wide range of activities and assess the remarkable progress made in combating malaria. It is a time for the global community to look ahead and continue to work towards total eradication malaria. Investments in malaria control have significantly reduced malaria deaths by one quarter within the last decade with overall child mortality rates reduced by approximately 20 percent.
By following the ABCD of malaria prevention we can break the malaria cycle. The ABCD is:
A: Awareness- you need the knowledge and understanding of the malaria cycle.
B: Bite prevention- if you do not get bitten by an infected anopheles mosquito, you cannot get malaria.
C: Chemoprophylaxis- use of preventive anti malaria medication.
This includes providing information on malaria and education of the public on the prevention and control of malaria.
This is most effective when a combination of preventive measure are used to prevent being bitten by the parasite. The two major lines of defense against mosquito bites are Mosquito control programs and Personal protection.
Mosquito Control programs aims at reducing the mosquito population by destroying larvae in mosquito breeding areas and by killing adult mosquitoes. These measures include:
• Draining of swamps, gutters, ditches and depressions
• Eliminating stagnant water: such as remove, destroy or cover outside containers that can hold water, keep plants away from vicinity of patios and doors
• Preventing mosquito access to living quarters (window and door screens, seal cracks, gaps and other openings around doors, plumbing fixtures, vents, AC’s).
• Residual spraying of housing & buildings
• Insecticide fogging around dwellings and living quarters.
• Spraying of open water with larvicide’s chemicals.
• The use of larvae eating fish in ponds & lakes.
Personal Protection aims at minimizing being bitten by mosquitoes. Measures include:
• Avoid mosquito-prone areas by avoiding dark, shady or bushy areas and outdoor night activities (even environments that mimic dusk and dawn)
• Stay in well-screened, mosquito-free accommodation during the dusk to dawn period. Keep windows and doors screened and in good condition.
• Use insect skin repellents at least 20% DEET: These come as lotions, sprays, and balms and should cover every exposed area of your body including the back of your neck and ears. It can also be used for children as well but not on babies younger than 2 months.
• Clothing: When you have to go out between dusk and dawn, wear long sleeve shirts and trousers or clothing reduce exposed skin
• Mosquito bed net: Is very effective and can reduce infant mortality by at least 20% for children that sleep under insecticide treated net. It can be washed and used again without losing their effectiveness as per instructions.
• Curtains can also be impregnated by the same insecticide solution used on mosquito bed nets.
This means taking a small quantity of medication as a preventative measure against a specific disease. Taking anti-malarial medication on a regular basis to prevent or suppress malaria symptoms. This means that the dose is lower than what is used for treatment, but high enough to create an antagonistic environment for malaria parasites that have entered the body after a bite. This minimizes the tissue and organ damage that the malaria parasite can cause. Some chemoprophylaxis kills the Malaria parasite when it is present in the blood, whilst other chemoprophylaxis will attack the malaria parasite in the liver therefore it should be taken exactly as prescribed. These medications are to be taken by the non-immune (those that were not born in malaria zone or lived there between 0-5years) and pregnant women.
The most common form of detection is microscope observation on a Giemsa-stained (a blue/purple stain) thick and thin blood film or rapid diagnostic test (RDT). All personnel should seek medical attention anytime you have such symptoms and think “malaria first”. Studies have shown that most Nigerians (semi-immune) treat malaria at home. Some years ago, the Federal Ministry of Health, Nigeria adopted artemisinin based combination therapy (ACT) as the first line drug for uncomplicated malaria but recently, resistance to artemisinin has been identified in some parts of the world therefore the World Health Organization (WHO) launched an emergency response to artemisinin resistance containment.
This campaign “Invest in the future: defeat malaria” will help strengthen the focus on malaria control globally and contribute to increase the funding needed in endemic countries for total eradication of this disease.
Written by O’ Reese of En-pact Solutions Limited, 2013
Twitter: @O Reese2