World Malaria day is today – Tuesday, April 25, 2017. Recognizing global efforts to control and perhaps one day eradicate this major killer that disproportionately affects my home country of Africa.
The WHO African Region continues to shoulder the heaviest malaria burden, accounting for an estimated 90% of malaria cases and 92% of malaria deaths in 2015. The WHO South-East Asia Region accounted for 7% of global malaria cases and 6% of malaria deaths. Three quarters of these cases and deaths are estimated to have occurred in fewer than 15 countries, with Nigeria and Democratic Republic of the Congo accounting for more than a third
Status of Malaria Today
Based on the WHO 2016 Malaria report there were 212 Million cases globally of Malaria. While we have seen some great progress with a decrease in Malaria infection rate between 2010 and 2015 of 21% and a decrease in the mortality rate of 29% we have a long way to go. Almost Half the population of the world is at risk from Malaria, and in 2015 an estimated 429,000 people died from Malaria. That’s the whole population of Miami dining every year.
More than 2/3 of the deaths that occur in children under the age of 5 and pregnant women are really susceptible – that’s a double hit on vulnerable populations.
The lifecycle encompasses the mosquito as carriers and transmission to humans. This is a great graphic summarizing the
Prevention and Treatment
The basis of prevention and treatment is tied to 3 basic methods
- Insecticides and Mosquito Nets
- Indoor spraying of insecticides
- Preventative Therapies for pregnant women, children and infants in Africa
The good news is that advances in Digital Health and mobile technologies that are bringing testing capabilities to many remote and underserved areas. Testing rates of suspected malaria cases have increased from 40% in 2010 to 76% in 2015 much of it due to rapid testing capabilities that economical and are increasingly available.
Sadly despite the progress, some of the mainstays of prevention and treatment are being impacted by the emergence of insecticide and drug resistance that has seen 60 countries reporting resistance to at least one of the 4 classes of insecticides and even more troubling 5 countries have reported drug resistance to the core compound used in antimalarials artemisinin
The report card by country is a mixed bag with some progress and success but increases in incidence in other areas
Many organizations have been working hard in this area and that includes the work by the Bill and Melinda Gates foundation has been focusing for many years on a World free of Malaria. They have invested over $2 Billion in grants spread across multiple areas prevention, mitigation and treatment.
Its a tricky virus that uses all sorts of clever subterfuge to fooling our bodies and the other carriers into ignoring the infection. There is even a clever “bending” of the red cell wall to allow the virus to enter more easily as demonstrated at Imperial College – Malaria parasites soften our cells’ defenses in order to invade:
However, now researchers led by a team at Imperial College London have found that the parasites also change the properties of red cells in a way that helps them achieve cell entry. The results are published in Proceedings of the National Academy of Sciences.
There are many fronts open and Papua New Guinea are one of the countries that dare to hope with encouraging progress that may bring about the end to the disease
In PNG, control measures – in particular the rollout of long-lasting, insecticide-treated bed nets – have resulted in the prevalence of malaria declining by more than 80% across the country since 2009. Cases reported at four sentinel sites have dropped from 205 to 48 per 1,000, surpassing all expectations.
New Strategies in Treatment of Malaria
There has been a lot of work on Vaccines for Malaria and it would appear some successful studies including this one from Germany
University of Tübingen researchers in collaboration with the biotech company Sanaria Inc. have demonstrated in a clinical trial that a new vaccine for malaria called Sanaria® PfSPZ-CVac has been up to 100 percent effective when assessed at 10 weeks after the last dose of vaccine.
So perhaps like Dengue – it may be “The Beginning of the End”. Let’s not let up – this is a major killer. Even with prevention and mitigation therapy as expatriates living overseas in Malaria ridden areas my mother still contracted the disease. We have had a global eradication program in action since the 1950’s – with advancement in science and understanding perhaps we are finally on the cusp of eradication?