End Malaria For Good

Every year, the World Health Organisation observes World Malaria Day on April 25. This year’s theme is ‘End malaria for good’. It is the result of a vision to create a malaria-free world that emanated from the ‘Global technical strategy for malaria 2016-2030’, which was adopted by the World Health Assembly in May 2015.
The strategy is meant to guide countries in their efforts to accelerate progress towards malaria elimination over the next 15 years. Its goals are to reduce the rate of malaria by 90 percent, reduce malaria death rates by at least 90 percent, eliminate malaria in at least 35 countries and prevent a resurgence of malaria in all countries that are malaria-free.
Malaria is present mainly in tropical and sub-tropical regions of sub-Saharan Africa, Asia and Latin America. So, Bangladesh is geographically located in a danger zone. The hilly regions of Chittagong and parts of Sylhet are areas where malaria is most common. Although Bangladesh has made significant progress in healthcare, malaria still remains a threat to our citizens.
There has been a major fall in malaria cases and deaths since 2000, mostly due to the spread of effective tools like insecticides, mosquito nets, diagnostic tests and anti-malarial drugs to treat and prevent the disease.
From 2000 to 2015, there has been a 37 percent decrease in malaria incidence globally. Still, almost half of the world’s 3.2 billion people have a risk of getting malaria. The figures for 2015 show that there were 214 million new cases of malaria, with 438,000 deaths, mainly in Africa. Millions of people still do not have access to services they need to prevent and treat malaria.
Malaria parasite is transmitted in humans by the bite of infected female mosquitoes, which usually bite between dusk and dawn. The parasite enters through the saliva present in the mosquito bite. After entering the blood, the organism spreads into the body using the blood as the route of travel. It can then settle into the liver, where it can mature and reproduce. Plasmodium (P) falciparum is the most deadly species of malaria parasite, which is prevalent mostly in Africa. In Bangladesh, more than half of infections is caused by P falciparum, while the rest by P vivax or P malariae, which are milder forms and less risky.
Common symptoms of malaria include fever, headache, chills, joint pain and vomiting, or even jaundice, which usually start after two weeks of the mosquito bite. Severity of the disease depends on a lot of factors, such as the parasite, the vector, the human host and the environment.
Diagnosis of malaria is done easily by microscopic examination of blood films or with antigen-based rapid diagnostic tests. Without proper treatment, malaria can cause re-infection, progress to severe illness and even death. Vulnerable groups include pregnant women, children and non-immune travellers. When severe malaria occurs in adults, multi-organ involvement is frequent.
Travellers can prevent malaria by chemo prophylaxis, which in simpler words is taking anti-malarial drugs during the time of travel to protect themselves. At present, there are no effective vaccines available, but research is being done.     
Malaria is highly associated with poverty and has a major impact on a country’s economic development since it leads to increased healthcare cost, loss of ability to work and a negative influence on tourism. An investment of US$8.7 billion is required annually to battle malaria.
WHO encourages multi-strategy to prevent, control and eliminate malaria. These include interventions such as use of insecticides, mosquito nets, indoor spraying, diagnostic tests in addition to treatment of confirmed cases with anti-malarial medicines. These measures have lowered the malaria burden across the globe, but transmission persists in many countries. Furthermore, there has been an increase in insecticide resistance, which means all the substances that used to kill mosquitoes are not as effective anymore. In addition, it is alarming that P falciparum malaria in Cambodia and Thailand is becoming difficult to treat due to multi-drug resistance, mainly to chloroquine. So, ultimately there is a chance that this form could spread to other parts of the world, making it difficult to control.  
Thus, we require a stronger global malaria surveillance system if we are to make disease response effective in vulnerable regions and prevent outbreaks. Together,  we can end malaria for good.

The writer is a fellow of Karolinska Institutet, Sweden.

End Malaria For Good

Every year, the World Health Organisation observes World Malaria Day on April 25. This years theme is End malaria for good. It is the result of a vision to create a malaria-free world that emanated from the Global technical strategy for malaria 2016-2030, which was adopted by the World Health Assembly in May 2015. The strategy is meant to guide countries in their efforts to accelerate progress towards malaria elimination over the next 15 years. Its goals are to reduce the rate of malaria by 90 percent, reduce malaria death rates by at least 90 percent, eliminate malaria in at least 35 countries and prevent a resurgence of malaria in all countries that are malaria-free. Malaria is present mainly in tropical and sub-tropical regions of sub-Saharan Africa, Asia and Latin America. So, Bangladesh is geographically located in a danger zone. The hilly regions of Chittagong and parts of Sylhet are areas where malaria is most common. Although Bangladesh has made significant progress in healthcare, malaria still remains a threat to our citizens. There has been a major fall in malaria cases and deaths since 2000, mostly due to the spread of effective tools like insecticides, mosquito nets, diagnostic tests and anti-malarial drugs to treat and prevent the disease. From 2000 to 2015, there has been a 37 percent decrease in malaria incidence globally. Still, almost half of the worlds 3.2 billion people have a risk of getting malaria. The figures for 2015 show that there were 214 million new cases of malaria, with 438,000 deaths, mainly in Africa. Millions of people still do not have access to services they need to prevent and treat malaria. Malaria parasite is transmitted in humans by the bite of infected female mosquitoes, which usually bite between dusk and dawn. The parasite enters through the saliva present in the mosquito bite. After entering the blood, the organism spreads into the body using the blood as the route of travel. It can then settle into the liver, where it can mature and reproduce. Plasmodium (P) falciparum is the most deadly species of malaria parasite, which is prevalent mostly in Africa. In Bangladesh, more than half of infections is caused by P falciparum, while the rest by P vivax or P malariae, which are milder forms and less risky. Common symptoms of malaria include fever, headache, chills, joint pain and vomiting, or even jaundice, which usually start after two weeks of the mosquito bite. Severity of the disease depends on a lot of factors, such as the parasite, the vector, the human host and the environment. Diagnosis of malaria is done easily by microscopic examination of blood films or with antigen-based rapid diagnostic tests. Without proper treatment, malaria can cause re-infection, progress to severe illness and even death. Vulnerable groups include pregnant women, children and non-immune travellers. When severe malaria occurs in adults, multi-organ involvement is frequent. Travellers can prevent malaria by chemo prophylaxis, which in simpler words is taking anti-malarial drugs during the time of travel to protect themselves. At present, there are no effective vaccines available, but research is being done. Malaria is highly associated with poverty and has a major impact on a countrys economic development since it leads to increased healthcare cost, loss of ability to work and a negative influence on tourism. An investment of US$8.7 billion is required annually to battle malaria. WHO encourages multi-strategy to prevent, control and eliminate malaria. These include interventions such as use of insecticides, mosquito nets, indoor spraying, diagnostic tests in addition to treatment of confirmed cases with anti-malarial medicines. These measures have lowered the malaria burden across the globe, but transmission persists in many countries. Furthermore, there has been an increase in insecticide resistance, which means all the substances that used to kill mosquitoes are not as effective anymore. In addition, it is alarming that P falciparum malaria in Cambodia and Thailand is becoming difficult to treat due to multi-drug resistance, mainly to chloroquine. So, ultimately there is a chance that this form could spread to other parts of the world, making it difficult to control. Thus, we require a stronger global malaria surveillance system if we are to make disease response effective in vulnerable regions and prevent outbreaks. Together, we can end malaria for good. The writer is a fellow of Karolinska Institutet, Sweden.