No.1 KILLER IN AFRICA
About 3.3 billion people - half of the world’s population - are at risk of malaria. Every year, this leads to about 250 million malaria cases and nearly one million deaths. People living in the poorest countries are the most vulnerable. Malaria is especially a serious problem in Africa, where one in every five (20%) childhood deaths is due to the effects of the disease. 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. This fact file presents the extent and effects of malaria and how it can be prevented and controlled.
Malaria is a disease which can be transmitted to people of all ages. It is caused by parasites of the species plasmodium that are spread from person to person through the bites of infected mosquitoes. If not treated promptly
with effective medicines, malaria can often be fatal.
About 3.3 billion people - half of the world’s population - are at risk of malaria. Every year, this leads to about 250 million malaria cases and nearly one million deaths. People living in the poorest countries are the most vulnerable.
One in five (20%) of all childhood deaths in Africa are due to malaria. It is estimated that an African child has on average between 1.6 and 5.4 episodes of malaria fever each year. Every 30 seconds a child dies from malaria in Africa.
Early diagnosis and prompt treatment are two basic elements of malaria control. Early and effective treatment of malaria can shorten the duration of the infection and prevent further complications including the great majority of deaths. Access to disease management should be seen not only as a component of malaria control but a fundamental right of all populations at risk.
Inappropriate use of antimalarial drugs in the past century contributed to widespread resistance in the malaria parasite to drugs such as chloroquine, leading to rising rates of sickness and death. Over the past decade, a new group of antimalarials – known as artemisinin-based combination therapies –
has brought new hope in the fight against malaria.
The main objective of malaria vector control is to significantly reduce the rate and number of cases of both parasite infection and clinical malaria. This is achieved by controlling the malaria-bearing mosquito and thereby reducing or interrupting transmission.
Long-lasting insecticidal nets can be used to provide protection to risk groups, especially young children and pregnant women in high transmission areas. This provides personal protection. The nets can also protect communities when coverage is high enough (more than 80% of people in a target community sleeping inside them). The nets are effective for a number of years (3 to 5 years, depending on models and conditions of use).
Indoor residual spraying is the most effective means of rapidly reducing mosquito density. Its full potential is obtained when at least 80 % of premises with malaria vectors are sprayed. Indoor spraying is effective for
3 to 6 months, depending on the insecticide used and the type of surface on which it is sprayed. (DDT is effective for longer periods, up to 12 months in some cases).
Pregnant women are at high risk not only of dying from the complications of severe malaria, but also spontaneous abortion, premature delivery or stillbirth. Malaria is also a cause of severe maternal anaemia and is responsible for about one third of preventable low birth weight babies. It
contributes to the deaths of an estimated 10 000 pregnant women and up to
200 000 infants each year in Africa alone.
Malaria causes an average loss of 1.3% of annual economic growth in countries with intense transmission. It traps families and communities in a downward spiral of poverty, disproportionately affecting marginalized and poor people who cannot afford treatment or who have limited access to health care. Malaria has lifelong effects through increased poverty and impaired learning. It cuts attendance at schools and workplaces. However, it is preventable and curable.
Diagnosis of malaria
Prompt and accurate parasitological confirmation of malaria diagnosis is part of effective disease management and will strengthen malaria surveillance.
The two recommended methods to support the clinical management of malaria are optic microscopy and rapid diagnostic tests based on lateral flow immunochromatography.
Once a diagnosis of malaria is established, the patient should be treated early with a safe and effective antimalarial medicine. Effective treatment should be started within 24 hours of the onset of symptoms, to avoid progression to severe malaria which is associated with a high case fatality rate.Antimalarial drug efficacy and drug resistance Antimalarial drug resistance hinders malaria control and is therefore a major public health problem. Tracking of evolving antimalarial drug efficacy patterns is essential for proper management of clinical cases and to determine thresholds for revising national malaria treatment policies. An example: battling malaria drug resistance along the Thai-Cambodian border
Quality of antimalarial medicines
Observing stringent quality standards for antimalarial medicines is crucial in order to ensure that safe and effective products are consistently made available for widespread use. Poor quality medicines and drug related adverse effects not only affect the health and lives of patients, they also damage the credibility of health care programmers and waste scarce resources.
Home management of malaria (HMM)
The HMM strategy aims to improve access to malaria diagnosis and treatment near the home.Prompt, effective, appropriate treatment key
It is vital that treatment starts within 24 hours of the onset of symptoms, to prevent progression to severe malaria or death. A strong health system would provide for reliable diagnosis as the basis for optimal treatment.
However, in most malaria-endemic areas, access to curative and diagnostic services is limited. The HMM strategy recognizes the importance of and seeks to improve the effectiveness of self-medication practices.
Financing and procurement
Pricing and affordability of artemisinin-based antimalarial medicines are important elements to increase access to quality, safe and effective
High risk groups
Some population groups are at considerably higher risk of contracting malaria and suffering from, or dying of it, than others. They include pregnant women, patients with HIV/AIDS, non-immune travelers, and in high transmission areas children under five years of age. They warrant particular measures for prevention of malaria and to mitigate this risk, taking into consideration their specific circumstances and the tools and strategies available.
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