Introduction

Malaria is a disease carried by mosquitoes

cause by a parasitic protozoan. Fever,
vomiting and headaches are among the
common symptoms. In more severe cases
yellow skin, seizures or even death may be
experienced. The disease is transmitted when
a female anopheles mosquito bites a living
animal. This
introduces the
mosquito's saliva
(which carries the
parasite) into the
animal's bloodstream.
If it makes its way to
the liver, it will mature
and reproduce. If not
treated properly it could be fatal. In 2013 there
was estimated to be just under 200 million
worldwide cases. 90% of which were found to
be in Africa.

Symptoms
The symptoms of malaria are generally noticed
within 8 to 25 days after being infected. If the
infected has taken anti-malaria medication it
may take longer for a noticeable change. Some
of these symptoms include fatigue, dry cough,
chills, headache,
spleen
enlargement and
nausea.The
common symptom
that most people
experience when
sick with malaria is
paroxysm. This is
the sudden occurrence of feeling cold, followed
by shivering and sweating. On average this will
occur every two days. Malaria in pregnant
women can often cause stillbirths.

Pathophysiology
Malaria develops in multiple stages. The
exoerythrocytic phase and the erythrocytic
phase. As mention before, it is when a mosquito
feeds on an animal's blood that its saliva mixes
with the blood stream. After entering, the
sporozoites will migrate to the liver, where they
will begin to mature and reproduce aseually. It
can take up to thirty days for reproduction to
begin. After a period in which the disease has
been dormant, the organisms differentiate
(change cell type). Following the rupture of their
hosts cells, they escape into the bloodstream
and infect red blood cells. Within the red blood
cells, the parasites begin to reproduce again
and will occasionally break out of the host's
cells to invade new red blood cells. The parasite
stays protected from most attacks since it is
invisible to the immune system.

Prevention of Infection
Some of the methods used to prevent infection
include prevention of bites (sleeping with a net
on one's self), mosquito elimination of
mosquitoes and medication. However, there is
no vaccine for malaria. In order for this malaria
to survive, it must have a large amount of
female anopheles mosquitoes, a high human
population density and high rates of
transmission. If any of the three mentioned
above were lowered enough, there is a chance
that the parasite may disappear from that
particular area. This has happened in Europe
and North America but it would need to be
completely eliminated to prevent it from
returning, as it could re-establish if conditions
were ever met again.
Reducing the population of mosquitos in known
as vector control. Insect repellent or insecticidetreated nets (ITN) have been proven to be very

effective in protecting children from malaria in

places where it is common. These all reduce
the risk of transmission, instead of a medication
which prepares the human body for it. The
spray simply kills the mosquito however they
can be slow to do so. They also often rely on
the mosquito to rest of the surface which is
usually only done after a bloodmeal. The net
however, prevents the mosquito from reaching
the target and (if it has been treated for
insecticides) will also kill the mosquito. In a
study conducted in 2000, it was found that
twenty million children used ITN. Although this
may sound high this is only 18% of the
population, leaving an estimated 89.6 million
unprotected.
If one plans to use medication instead, they are
advised to begin use two weeks before they will
be at risk of being bitten. This is because they
can be slow to take effect. It has been found
that taking such drugs during pregnancy can
reduce the risk of anemia.

Treatment
Malaria can be treated with antimalarial
medications, which particular one to use
depends on the severity of the individual's case.
If the malaria is uncomplicated, it can be treated
orally. If this malaria is more severe, it may
involve hospitalisation. Treatment of blood
staged and clearance of liver forms may be
necessary. Is the malaria is even more
dangerous, quinine in both children and adults
may be necessary. This is a crystalline
compound present in cinchona bark and is used
as treatment.
In recent years, drug resistance has began to
poses as an increasingly bigger problem. This
is due to over dependence and over use. The
parasite begins to adapt and becomes immune.
This is also why it has become very difficult to
create a vaccine for it.

Eradication Efforts
There have been several noteworthy attempts
throughout history to wipe
out malaria. An
organisation known as
Malaria No More was
founded in 2006. The goal
was to eliminate malaria
from africa by 2015.
Several vaccines are in clinical trial. As of 2012,
Tuberculosis and Malaria Foundation as well as
The Global Fund to Fight Aids have distributed
over 230 million insecticide-treated nets. Malaria
has been defeated before in countries such as
The United States of America and a large portion
of European countries. One of the major problems
faced when trying to eradicate it today, is how you
do so in a third world country.

Malaria

Ran O Mahoney