Malaria is a life-threatening disease primarily found in tropical countries. It is a serious disease caused by parasites, spread to humans through bite of an infected mosquito and can be life-threatening if not treated on time although it is very much preventable and curable. The Malaria parasites would typically start showing symptoms in 10-15 days of infection, though it’s possible that the parasites remain dormant for up to one year to infected person. The common symptoms of malaria include fever, chills, headache, nausea, vomiting, fatigue, abdominal pain, rapid breathing, cough among others. According to Dr RVS Bhalla, Director Internal Medicine, Fortis Escorts Hospital, Faridabad some lesser-known symptoms of Malaria are Low platelet count or WBC count, Low blood sugar, Kidney failure, Unconsciousness or seizures. Dr Vikrant Shah, consulting physician, intensivist and infection disease specialist, Zen Multispeciality Hospital Chembur elaborates on some other common and rare symptoms of malaria like Myalgia, Jaundice, Malaise, Arthralgia, Anaemia, Shortness of breath. Malaria can put pregnant women at high risk of death, miscarriage, premature delivery and neonatal death. The mosquito-borne parasitic infection, can cause severe symptoms in expecting mothers, including severe anemia, respiratory distress and infant mortality. Pregnant women are three times more likely to suffer from severe disease as a result of malaria infection compared to those who are not, and have a mortality rate from severe disease. Pregnant women should be educated regarding avoiding mosquito bites by using insecticide-treated bed nets (ITNs), mosquito repellants, long sleeved clothing and intermittent prophylactic therapy, in consultation with the physician, whenever feasible. Malaria is 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. We can prevent Malaria disease by taking following measures to reduce the risk of mosquito bites. a) Apply 20-35% N, N-Diethyl-Meta-Toluamide insect repellents to the body b)When outside at night, wear a dress with long sleeves and long pants c) Use mosquito nets over the bed during the night d) Before going to bed, spray pyrethrin or a related insecticide in the bedroom e) N ever allow stagnant water in household surroundings f) Always close the water tubs with a lid. 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 Pacific campaigns. The COVID-19 pandemic has been a part of our daily lives since last two years. Authorities in 227 countries and territories have reported about 676.6 million Covid 19 cases and 6.9 million deaths since China reported its first cases to the World Health Organization (WHO) in December 2019. Till date, more than 686,447, 109 people have been infected, 6,859, 496 have died and 659,025,460 have recovered till noon 23 April 2023. The US remains the worst-hit country with 106,542,201 COVID-19 cases and 1,159,011 deaths, followed by India with 44,891,989 cases and 531,329 deaths. China has caused an outbreak with a continuous breach of borders involving 231 countries and territories worldwide and 2 international conveyances. 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. World Malaria Day is observed annually on 25 April, to bring global attention to the efforts being made to bring an end to malaria, and encourage action to reduce suffering and death from the disease. It is an occasion to highlight the need for continued investment and sustained political commitment for malaria prevention and control. It was instituted by WHO Member States during the World Health Assembly of 2007. This days 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. The theme of this year’s World Malaria Day is – “Harness innovation to reduce the malaria disease burden and save lives.” WHO is calling for investment and innovation in vector control, diagnostics and treatments to help countries to eliminate malaria after several years of stalled progress. Throughout much of the world, including Africa, health care providers typically treat malaria cases with a combination of drugs known as artemisinin-based combination therapy (ACT), the World Health Organization (WHO) recommended first-line treatment for uncomplicated malaria. These drugs—alongside the scale-up of other proven interventions such as insecticide treated bed nets, preventive medicines, and insecticide spraying, together with strengthened systems for malaria surveillance—are part of the reason the annual number of malaria deaths has been driven down significantly since 2000. Fifteen years ago, malaria killed nearly 1.2 million people annually. Today, the collective efforts of USAID, CDC, and other global health partners have helped cut that number nearly in half. However, continued long term drug efficacy should not be considered a foregone conclusion. Current antimalarial drug regimens cannot be relied upon forever. One of the looming threats to malaria elimination efforts around the world is the emergence and spread of parasites that are resistant to antimalarials like ACTs. In the face of a dual threat of antimalarial drug resistance and COVID-19, countries of the Greater Mekong subregion have also made major strides towards their shared goal of elimination by 2030. In the 6 countries of the subregion, the reported number of malaria cases fell by 97% between 2000 and 2020. Malaria deaths were reduced by more than 99% in the same period of time. 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. World Malaria Day 2023 will be marked under the theme “Time to deliver zero malaria: invest, innovate, implement”. At WHO, we’re focused on raising awareness about the need to “implement” the tools and strategies we have available today to reach those who continue to be unreached across the Western Pacific. Reaching these populations with malaria prevention, diagnosis and treatment is a critical strategy for achieving global malaria targets and delivering on the promise of “zero malaria.” WHO is working with countries and areas in the Region to develop and implement intensification strategies, such as targeted drug administration, fever screening and treatment, and rapid response to all malaria cases. Although antimalarial drug resistance remains a concern, the Western Pacific countries of the Greater Mekong subregion, including Cambodia, Lao People’s Democratic Republic, and Viet Nam have seen promising results to accelerate Plasmodium falciparum elimination. Between 2000 and 2021, these three countries reported a nearly a 73% decrease in all indigenous malaria cases and a 92% decline in indigenous P. falciparum malaria cases. All countries are on target to meet the 2023 elimination target for Plasmodium falciparum malaria and all forms of human malaria by 2030. It is important, we work to defeat malaria. Funding should be prioritized for the most marginalized and hard-to-reach populations who are less able to access services and hardest hit when they become ill. There is an urgent need to make more effective use of available tools and strategies to prevent, diagnose and treat malaria, particularly among unreached populations. 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. It is concluded that in current COVID-19 virus threat everyone should follow health advisory as much as possible to control Malaria as well as control spread of COVID-19 infection.
(The authors write exclusively for the opinion pages of “Kashmir Horizon”.. The views, opinions, facts, assumptions, presumptions and conclusions expressed in this article are those of the authors and aren’t necessarily in accord with the views of “Kashmir Horizon”.)
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