Malaria Is A Major Public Health Problem

Background - Malaria is a water borne disease. It is spread by a parasite-carrying mosquito. It kills many people and reduces a country 's capacity to develop. There are different strategies to combat malaria. Around half the population is at risk of malaria and this disease is active in 106 counties across Africa, Asian and the Americas (see source 3). the global annual mortality from malaria is between 1.5 - 3 million deaths, or between 4000 and 8000 each day. Developing countries are most vulnerable to Malaria and as shown on source 2 Malaria has been spread across many various other countries including in Europe, but these countries have eradicated Malaria.

There have been many attempts at preventing malaria, none of which have been very successful. These have usually involved protecting human beings from mosquitoes, the dreaded carriers

As stated by the World Health Organization, dengue fever is reportedly the fastest spreading vector disease in the world (Dengue Vaccine Initiative, 2014). There are numerous prevention and treatment interventions that have been implemented across the globe. However, the prevalence of dengue fever is not diminishing, specifically in underdeveloped countries that are lacking extreme measures of mosquito control. Due to the dengue fever being vastly influenced by external factors, community efforts are the greatest weapon against decreasing incidence rates, manipulating the environment, and transforming individual health behaviors.

Malaria is a parasite that has been impacting the world for the past couple of centuries. The illness associated with malaria gives intense fevers, chills, terrible headaches, muscle pains and can be deadly if not treated properly. Although overall malaria cases have decreased from 262 million in 2000 to 214 million in 2015, it is still an issue to be concerned about today.1 There have been developments of a vaccine against this parasite, but the parasite has adapted to the vaccine and developed a resistance to it, thus rendering it ineffective. The p. falciparum and p. vivax strains of malaria is what is causing problems as these resistant strains have popped up in much of Asia and Africa and a couple of countries in South America.1 This can potentially be a problem for the military and more specifically the Air Force as multiple countries where the Air Force deploys are infected with these resistant strains of malaria. It can be seen through the background and history of the fight against this parasite that the chemistry behind an antimalarial vaccine is important to the Air Force.

According to the CDC, in 2010 there were over 216 million cases of malaria that resulted in the 655,000 deaths (Centers for Disease Control and Prevention, 2012). The incidence of malaria and the concomitant death toll illustrate the acute need for effective measures of prevention. Furthermore, over 91% of the deaths from malaria occur in Africa and furthering the case of preventative measures (Centers for Disease Control and Prevention, 2012). Transmission of malaria via mosquitos illustrates the difficulty in both containment and eradication of the public health risk.

The use of the various interventions in preventing malaria infections and deaths has faced a number of challenges including;

Despite the recent advancements, however, there remains no opportunity for complacency. Malaria continues to represent a perilous public health challenge and one of the most prevalent and lethal infectious agents across Africa, Asia and the Americas. Data released in December 2013 indicates that there were in the range of 207 million cases of malaria in 2012, and an estimated 627,000 related deaths – most particularly in children under five and expectant mothers.2 In Africa today, it can be predicted that a child will die every forty-five seconds as a result of malaria.3 To quote WHO Director-General Dr Margaret Chan, “the fact that so many people are dying from mosquito bites is one of the greatest tragedies of the 21st century”.1 In 2008, the Roll Back Malaria (RBM) Partnership unveiled its Global

For ages malaria has affected mankind in almost all parts of the world. It has left a deep imprint on people who have been affected with the disease, and even today in countries where epidemics are common, malaria is a constant threat to people's daily lives. Malaria is caused by protozoan parasites of the genus Plasmodium (phylum Apicomplexa), and there are four species in the genus that cause the disease in humans. Their primary hosts and transmission vectors are female mosquitoes of the genus Anopheles; humans act as intermediate hosts. Places near the equator with a warm, subtropical climate are most susceptible to malaria endemics. More than half of the

Despite the information that has been presented, data shows that malaria infection and mortality rates have been decreasing worldwide for several years. The number of patient deaths due to malaria has decreased by 47% in the last ten years. Since 2000, infection prevalence in children 2-10 years old dropped from 26% to 14% and total prevalence fell from 173 million to 128 million worldwide (WHO, 2014). A goal the Gates Foundation has had since 2007 is the eradication of malaria and the decreasing mortality rates has been partly due to their support of research for and prevention of malaria (Gates, 2014).

Malaria, a treatable and preventable disease, is still a major public health threat in spite of years of numerous control and intervention strategies. In 2015, the World Health Organization reported 214 million new malaria cases and more than 430,000 malaria related deaths. Sub-Saharan Africa accounted for 88% of the new cases and 90% of the deaths, with pregnant women and children under five being at the highest risk of infection. Malaria is a devastating disease that accounts for about 10% overall disease burden in Africa and more than 40% public health expenditure (Ntonifor & Veyufambom, 2016). The high malaria incident rate in sub-Saharan Africa is attributed to high transmission rates from highly efficient vectors. Hence the World Health Organization recommends vector control and other prevention strategies like use of long lasting insecticide treated nets (LLINs), indoor residual spraying (IRS), and intermittent preventative treatment. This literature review will analyze past studies and World Health Organization reports to examine adverse outcomes of malaria infection among different populations, common interventions that have been used to control malaria infections, challenges faced in malaria prevention, and prioritizing strategies to control and prevent Malaria in Africa.

Infectious diseases are the leading cause of death all over the world [1]. Malaria, also called plasmodium infection, is one of the most important human infectious diseases threatening the lives of millions of people every year. According to WHO malaria report, globally, an estimated 3.2 billion people in 97 countries and territories are at risk of being infected with malaria and developing disease, and 1.2 billion are at high risk [2]. Although the disease has been eradicated in most areas, it’s still widespread in some regions [2]. The biggest challenges in controlling malaria disease are the emergence of anti-malarial drug resistance and insecticide resistance in parasite and mosquito, respectively [3-5]. Therefore, there is an urgent need to develop novel intervention strategies such as vaccines to reduce the burden of malaria morbidity and mortality. Malaria is commonly associated with poverty and has a major negative effect on economic development [6]. Oral vaccines offer exciting possibilities for reducing the burden of diseases especially in developing regions of the world. Oral vaccines are inexpensive, easily administered (needle-free) and capable of being stored and transported without refrigeration [7]. In contrast to injected vaccines, oral vaccines are mucosal-targeted, which cause stimulation of systemic as well as mucosal

The economic and non- economic effects of malaria is so dire that the international community cannot ignore it anymore. There is the need for adequate research and funding into the study and proper understanding of the disease so that the proper steps can be taken to completely

The successful treatment of malaria infections solely dependent upon the use of the most effective anti-malaria drugs to eradicated the parasite from the individual 's blood. The treatments differ for complicated and uncomplicated infections. The greatest obstacle healthcare workers face is the increased resistance of the Plasmodium parasite to drug therapy. The Plasmodium falciform species has become increasingly resistant in the regions affect by the strain (1).

Malaria is acute febrile illness caused by infection of red blood cells with protozoan parasites of genus plasmodium. The four Plasmodium species that infect humans are P. falciparum, P. vivax, P. ovale and P.malariae. The incubation period of malaria is 7 days or more (usually 10-15 days). The

The current interventions in place are vector control and insecticide treated mosquito nets. Vector control involves the reduction of vector habitats through the use of chemical larvicides and adulticides and of biological control agents. This method is hindered however, by a weak program capacity, as well as by the absence of well-defined indicators and program targets along with a poor understanding of efficacy and cost-effectiveness of control measures particularly in terms of reducing transmission (World Health Organization). Not only this, but pesticides can also be extremely harmful to the environment and can end up in the water supply due to runoff, leading to a further potential harm for humans and animals. An important factor in vector control is that all insecticides run the risk of mosquitos becoming resistant. The Malaria Journal states that, mosquito nets often go unused due to the heat associated with sleeping under them and perceived mosquito density. Nets are usually treated with insecticide and mosquitos are beginning to become resistant to the particular pesticide used. Nets, though efficient if used, must be replaced every three to four years. There are other interventions in place, such as public awareness campaigns.