Gousia Jeelani & Dr. Bilal A. Bhat
Malaria is a severe tropical disease spread by mosquitoes and if it isn’t diagnosed and treated promptly, it can be fatal. It’s typically transmitted through the bite of an infected Anopheles mosquito. Infected mosquitoes carry the Plasmodium parasite and when this mosquito bites a person, the parasite is released into bloodstream of a person. Once the parasites are inside the body of a person, they travel to the liver, where they mature. After several days, the mature parasites enter the bloodstream and begin to infect red blood cells. The parasites inside the red blood cells multiply within 48 to 72 hours, causing the infected cells to burst open. The parasites continue to infect red blood cells, resulting in symptoms that occur in cycles that last two to three days at a time. There are four kinds of malaria parasites that can infect humans: Plasmodium vivax, P. ovale, P. malariae, and P. falciparum. P. falciparum causes a more severe form of the disease and those who contract this form of malaria have a higher risk of death. An infected mother can also pass the disease to her baby at birth. This is known as congenital malaria. Malaria is transmitted by blood, so it can also be transmitted through an organ transplant, a transfusion and use of shared needles or syringes. The symptoms of malaria typically develop within 10 days to 4 weeks following the infection. In some cases, symptoms may not develop for several months. Some malarial parasites can enter the body but will be dormant for long periods of time. The common symptoms of malaria include: shaking chills that can range from moderate to severe, high fever, profuse sweating, headache, nausea, vomiting, abdominal pain, diarrhea, anemia, muscle pain, convulsions, coma and bloody stools. In case any one feel any symptom of malaria, he/she should approach to a doctor. The doctor will be able to diagnose malaria. The doctor will review health history, including any recent travel to tropical climates and a physical examination. The doctor will be able to determine if a person have an enlarged spleen or liver. If anyone have symptoms of malaria, the doctor may order additional blood tests to confirm diagnosis. These tests will show whether a person have malaria, what type of malaria a person have, if infection is caused by a parasite that’s resistant to certain types of drugs and if the disease has caused anemia. Malaria can cause a number of life-threatening complications such as swelling of the blood vessels of the brain, or cerebral malaria, an accumulation of fluid in the lungs that causes breathing problems, or pulmonary edema, organ failure of the kidneys, liver, or spleen, anemia due to the destruction of red blood cells and low blood sugar. As we are moving through the difficult face of the COVID-19 pandemic and today is the world’s malaria day, time has returned to make us know that where we stand. Nearly hundreds of years ago, a pandemic of that time, malaria triggered widespread deaths and it was up to the world to draw a lesson from this pandemic, but the harsh reality is that we have not. The country’s health system had not been up to date, had it been uplifted then we would not have encountered such problems. Number of patients across the world has now risen to over 25 lakh, but we can’t get effective epidemic surveillance. Our emphasis has never been on research but has been on other issues. Priority has never been healthcare nor research, and that is why we are not able to increase our frequency of testing. World Malaria Day held on 25 April is an annual event to increase consciousness of the worldwide initiative to monitor and effectively eliminate this dreadful disease. World Malaria Day, first celebrated in 2008, originated from the Africa Malaria Day, an occurrence that African government have observed since 2001. In 2007, at the World Health Assembly’s 60th session (a conference funded by the World Health Organization [WHO]), it was suggested that the Africa Malaria Day be modified to World Malaria Day in order to highlight the prevalence of malaria in countries all over the world and to increase knowledge of the global struggle against the disease. Malaria occurs in over 100 countries across the globe, and about 900,000 people suffer each year from the disease. However, malaria may be avoided using drugs and other precautionary steps, such as bed nets filled with insecticide and applying insecticide indoors. On World’s first Malaria Day the UN Secretary-General Ban Ki-moon stressed the need to increase the availability of bed nets, medications, public health facilities and skilled health workers in malaria-affected areas of the world. Ban questioned global intervention initiatives such as the Bill & Melinda Gates Foundation, the Roll Back Malaria Project and the World AIDS, Tuberculosis and Malaria, Fund by announcing that he wants such standardized coverage to be in effect by the end of 2010. This appeal for action inspired the development of the Global Malaria Action Plan (GMAP), an ambitious concerted initiative to minimize malaria incidence worldwide. Regulation, removal, and analysis are the three elements of this technique. Research to create innovative medications and alternative methods for treatment are the key attempts to monitor and treat the malaria from places that have been badly hit by the epidemic and thereby eradicating it. The plan’s long-term target is for infectious epidemic eradication by 2015.
A plasmodium parasite-caused illness, spreading through the bite of contaminated mosquitoes is the malaria. Malaria incidence differs, depending on plasmodium types. Symptoms include chills, cough, and vomiting, which typically arise a few weeks after chewing. People traveling to places where malaria is frequent generally take preventive medicinal products before, during and after their journey. Treatment requires medications which are antimalarial. Malaria’s existence spans from its ancient roots as a zoonotic disorder of Africa’s primates up to the 21st century. The first proof of malaria parasites was discovered in mosquitoes that have been preserved in amber from the Paleocene era, around 30 million years ago. Around 10,000 years ago, malaria started to have a significant effect on human life, happens to coincide with the advent of Neolithic progressive cultivation a widespread and potentially lethal human infectious disease which at its peak infested every continent except Antarctic. Malaria prevention and care has been a subject of research and medicine for decades. Study interest has been based on their biology after the detection of the parasites that causes it, as well as that of the mosquitoes that spread the parasites. Traditional herbal medicines have been used for the treatment of malaria for thousands of years. The first successful malaria cure originated from the bark of the cinchona tree which contains quinine. Following the discovery of the association with mosquitoes and their larvae in
the early 20th century, mosquito protection measures such as widespread use of insecticide DDT, swamp drainage, covering or oiling the surface of accessible water bodies, indoor residual spraying and the use of insecticide-treated nets were introduced. Prophylactic quinine has been used in tropical regions of malaria, and modern medicinal medications such as chloroquine and artemisinine have been used to combat the scourge. Artemisinin today is found in any medicine used in malarial therapy. By using artemisinin in combination with other drugs, Africa’s mortality rate dropped by half. Malaria was the most serious health threat faced by U.S. forces in the South Pacific during World War II, infecting over 500,000 people. According to Joseph Patrick Byrne, “Sixty thousand American soldiers died of malaria during the African and South Pacific campaigns. The appearance of novel coronavirus (COVID-19) has introduced new representatives to the human coronovirus family. Till date, more than 25 lakh people have been infected and almost two lakh people have died. China has caused an outbreak with a continuous breach of borders involving 210 countries and territories worldwide and 2 international conveyances. The disease was designated 2019-nCoV on January 7th by the World Health Organisation (WHO). On 11 February 2020, the WHO modified its name to COVID-19 and the virus responsible for this epidemic was also called Serious Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) owing to the 2003 SARS epidemic genetic association with coronavirus. The clinical trials for the treatment are on cards but on ground it is true that there is no drug in line to cure this deadly disease. We cannot ignore the stuff that both the malaria and covid-19 are the pandemic and that the WHO has classified them as a health emergency. Time is to introspect that a pandemic that occurred at least before 100 years is still a nightmare for the world to be declared as malaria free, how much time it will take to be COVID-19 free. When almost all the globe has been influenced by this disease the dire need of the hour is again the pledge of the UN and the WHO for the provision of drugs, public health services and trained health staff. Health should be provided a priority because it has correctly been stated that health is wealth. World malaria day is again with a message that we need to introspect first on individual basis that are we fulfilling the criteria for the social responsibilities that are upon us. On individual basis we need to focus on clean environment, clean water personal hygiene, etc., once we will do that there will be a global change. As world malaria theme for 2020 is Zero Malaria Starts with Me it puts responsibility on our shoulders. We have made tremendous strides in the battle against malaria over the last two decades, saving more than 7 million lives and avoiding more than 1 billion cases of malaria. However, as long as malaria remains, it affects the weakest and most endangered populations and has the ability to re-emerge in periods of public health disaster – like the COVID-19 challenge we are facing today. As the world deals with COVID-19, this World Malaria Day should also emphasize the value of sustaining strong health services, alongside developing ones, to eliminate chronic diseases such as malaria. COVID-19 tightens regional health networks and threatens households, populations and states. So, the message is clear, stay focused to defeat the pandemic because after all we will rise again as we did in past. The World Malaria Day and continued awareness and prevention, as well as lobbying for better political support must continue and increase in order to eradicate the disease and prevent deaths from it. Investment and interest from governments is essential for this continued fight against Malaria and related deaths.
(Dr Bilal A Bhat is an Associate Professor at SKUAST Kashmir –Shalimar Srinagar and Gousia Jeelani a research scholar at Kashmir University Srinagar. Both the author write exclusively for “Kashmir Horizon”. Views are their own)