Malaria Menace

Why prevention is still the best buzzword for malaria

MosquitoIt's a tiny airborne female, and one of our deadliest enemies, with an explosive biology.

As she "scents" on exhaled carbon dioxide, she determines whether you are "game" to her "cooking" instincts. Next? She strokes your skin gently, pours her saliva, and pricks you to draw blood. In the process, she plants a "million murdering seeds" of microbes into your system.

Though puny, mosquitoes have destroyed civilisations, and rewritten history.

Relentless curse

Malaria has been a relentless menace since olden times. In ancient Egypt, malaria was attributed to occur mainly in marshy, lowland areas [mal'aria = bad air].

Malaria is said to have claimed many illustrious victims, down the ages: Alexander, the Great, in 323 BC; Pope Innocent III, in 1216; Dante, the great poet, in 1321; Raphael, the legendary artist, in 1520; Oliver Cromwell, in 1658; and, George Washington's widow, in 1802, to name a few.

Malaria, in factual terms, is actually four diseases, caused by four related parasites, each having distinctive characteristics: Plasmodium falciparum, P vivax, P ovale, and P malariae. It is the P falciparum form that is notoriously complicated and deadly.

Beyond the malarial bite

The bite of a female anopheles mosquito transmits infection to people - call it the [in]famous malarial "nibble," or what you may. About 8-10 days later, the victim is literally shaken with high fever.

Now a target of intense international effort that employs some of the most advanced techniques available at the frontiers of modern science and medicine in an attempt to discover new weapons for fighting an old enemy, malaria continues to claim over a million lives in the tropics alone - on an annual basis.

Malarial patterns, in India, are legion. Though the government of India spends almost 30 per cent of its entire healthcare budget on malaria control, there has been no let-up in outbreaks of the disease. For several reasons - most notably, the ineffectiveness of DDT and other insecticides, chloroquine's losing battle with its potency, besides man-made environmental changes that abet mosquito breeding, not to speak of bad hygiene. What's more, developed nations, especially the US, that used to earlier fund most of the malaria research, are trimming, and even cutting their budgets.

Protection from mosquitoes: Basic facts

Malaria is commonplace in many countries; it is also a serious and sometimes fatal disease.

There is no vaccination available yet against malaria and no one knows when this would be; however, you can protect yourself by the avoidance of mosquito bites, because mosquitoes cause as much inconvenience owing to local reactions as the bites themselves, and from the infection they transmit.

Mosquitoes have a disciplined lifestyle. We can use this to our advantage. The female anopheles, for example, enters human dwellings in the evening hours and hides within clothes that are hanging or in dark corners, to come out and bite after midnight.

  • Keep the windows and doors closed between 5 pm and 9 pm; screen windows if possible
  • Avoid mosquito bites, especially after sunset. Best to wear long-sleeved clothing and pyjamas at night. Mosquitoes often bite through thin clothing. You may spray/apply a repellent on your clothing, and, of course, on exposed skin
  • Repellents may be sprayed in the room - but, sparingly.
  • When you sleep in an unscreened room, or outdoors, the best thing to do is use a mosquito net. They are easy-to-carry and lightweight.
  • Contrary to popular belief garlic, vitamin B, and ultrasound devices do not prevent bites.

Medications

  • If you intend to travel, you need to take anti-malarial tablets, which your therapist can prescribe, one to three weeks before departure [depending on the drugs]
  • You ought to take the tablets regularly, preferably during, or after, a meal
  • Doctors often advise that you continue taking tablets for four weeks after you have returned. This is suggested to cover the incubation period - the development of an infection from the time the pathogen enters the body until signs, or symptoms, first appear. Some medications require short post-travel-return treatment - of just about a week.

Preventing malaria

Any preventive step, if it is to work, should interrupt the life-cycle of the malarial parasite. The weakest link is the egg-laying phase of the mosquito. The wily insect nourishes its eggs with our blood and lays eggs in stagnant water - such as your overhead water tank, or pools of water that collect in the vicinity. It is imperative to clear the stagnant water regularly; this has proved to be the most difficult part, mainly due to the indifference of the powers-that-be and the community at large.

Interestingly, one novel method has worked well - the bio-environmental strategy, which employs fish, like guppy, to eat the mosquito larvae - among others.

Researchers expect new vaccines and medicines that are in use, or on the anvil, to be the touchstone in the future development of malaria prevention, control, and treatment. This also includes a multi-stage vaccine/medication that would be capable of attacking the parasite at different stages of its life-cycle.

If everything goes well - and, the potent weapon does achieve its full potential and is made affordable - we will have good reason to celebrate a huge victory in one of mankind's longest and fiercely-fought battles in history.

Malaria: Fact-file

  • Malaria is re-emerging as the #1 "killer-disease"
  • Malaria is caused by Plasmodia parasites and spread by the female anopheles mosquito
  • Malaria is characterised by fever with chills and rigors, but uncharacteristic symptoms are not uncommon
  • Blood test for malaria parasite should be done in all cases of fever to confirm diagnosis
  • Treatment of malaria is simple and inexpensive in most cases. However, delay can be fatal in P falciparum-infected patients.

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