25th April ,World Malaria Day

Zero malaria begins with me

When the world trembles against the Covid-19 virus, let’s not forget about another infectious disease that is much more dangerous for the inhabitants of a significant part of the world. Malaria kills hundreds of thousands of people every year, mostly children. To highlight this problem, the World Health Organization (WHO) in 2008 established World Malaria Day, celebrated on April 25. Its purpose is to increase public awareness of malaria and reduce the scale of the disease and its effects.

What is malaria?

Malaria is a life-threatening disease caused by one or more of five species of unicellular protozoan of the genus Plasmodium.
The parasite is usually transmitted at night – from dusk to dawn – by the biting female mosquito Anopheles. Mosquitoes do not buzz and leave no marks in the place of the bite, so the person does not know that he was bitten. When the mosquito bites, the parasite is released into the bloodstream. When the parasites enter the human body, they migrate to the liver, where they mature. After a few days, mature parasites enter the bloodstream and begin to infect red blood cells.

Within 48 to 72 hours, the parasites in the red blood cells multiply, causing infected cells to open. The parasites continue to infect red blood cells, causing symptoms usually found in cycles of two to three days.
   Because malaria-causing parasites affect red blood cells, people can become infected with malaria after exposure to infected blood, including:

  • From mother to unborn child
  • Organ transplant
  • Blood transfusion
  • Use of common needles or syringes

Malaria is the cause of 5 percent of world deaths. Every year, around 210 million people become infected with malaria, and around 440,000 die from this disease. Most people dying of this disease are young children in Africa. Some varieties of the malaria parasite, which usually cause milder forms of the disease, can persist for years and cause relapses.

Malaria in Tanzania

Tanzania has the third-largest population at risk of malaria in Africa: more than 90% of the population lives in areas with malaria. Every year, 10-12 million people get malaria in Tanzania, and 80,000 dies of this disease, mostly of children.
The risk of malaria is highest in the Kager region on the west side of Lake Victoria, and lowest in the Arusha region. Fortunately, malaria has dropped significantly over the past decade. In recent years, the number of children dying from malaria has halved.
Unfortunately, climate change and the widespread flow of people complicated the fight because mosquitoes are now in places previously free from malaria.

Tanzania, along with other African countries, is running the campaign “Zero malaria begins with me.” The campaign began during the Malaria Community Day of South Africa (SADC). At the national level, the campaign aims to mobilize political will, additional resources (especially from national sources), and community responsibility for the fight against malaria. Significant progress has been made in Africa, reducing mortality by 40% and reducing incidence by 20% only in this decade. However, a report by the World Malaria World Health Organization (WHO) has shown that the number of malaria cases worldwide has increased over the past two years. “Zero Malaria begins with me,” aims to accelerate progress by inspiring movement across the continent to eliminate malaria.

Malaria on Zanzibar 

The Zanzibar archipelago has also significantly increased malaria control over the past decade to eliminate malaria. Despite the consistent implementation of effective tools since 2002, complete elimination has not been achieved. Imports of parasites from outside the archipelago are believed to be an important cause of malaria persistence and play an increasingly important role in the incidence of malaria in Zanzibar. The archipelago has a high level of connectivity with the mainland, and therefore malaria imported through human travel can play an increasing role in transmission.
  At the end of 2019, malaria increased in some areas of Zanzibar, including on the outskirts of Stone Town. The incidence of malaria is still less than one percent, but the Zanzibar authorities are urging residents to take precautions, including using mosquito nets and maintaining the cleanliness of the surroundings, to minimize the spread of malaria.
Zanzibar with all means to eliminate malaria. Drones are currently being tested to see if they can help fight malaria on the island. Drones spray silicone-based fluid onto rice fields, wherein stagnant water, mosquitoes carrying malaria lay their eggs. The substance spreads through water and prevents eggs from hatching. We hope that this will significantly reduce the number of mosquitoes carrying malaria on the island.
Spraying drones is a test to see if this can help the Zanzibar government achieve its goal – eliminate malaria in the archipelago by 2023.

What are the symptoms of malaria?

What are the symptoms of malaria?
Malaria symptoms usually appear within 10 days to 4 weeks after infection. In some cases, symptoms may not develop for several months. Some malarial parasites can enter the body and remain inactive for a long time.
Initial malaria symptoms may be similar to flu symptoms: headache, fever, chills, joint pain, vomiting, and convulsions. Often, however, people suffering from malaria feel very bad, have a high fever and chills. Some malaria sufferers experience cyclic malaria attacks. The attack usually starts with a sudden chill, then comes chills and convulsions, followed by a high fever and sweating, sometimes vomiting. After a few hours, it returns to normal temperature. Such attacks occur every 2-3 days.

Common symptoms of malaria are:

  • High fever
  • Chills
  • Headache
  • Nausea and vomiting
  • Muscle pain and fatigue

Other symptoms may include:

  • Heavy sweating
  • Chest or stomach pain
  • Cough
  • Diarrhea
  • Convulsions
  • Coma
  • Bloody stools

Symptoms of P. falciparum are more serious and include changes in behavior, confusion, convulsions, anemia, respiratory failure, renal failure, coma, and shock.

Risk factors

The biggest risk factor for developing malaria is to live in or visit areas where the disease is common.
People at increased risk:

  • Small children and babies
  • Elder people
  • Travelers arriving from areas without malaria
  • Pregnant women and their unborn children

Poverty, lack of knowledge, and little or no access to health care are also contributing to the death of malaria worldwide.

Usually, people who are exposed to malaria for a long time develop partial immunity that can reduce the severity of their malaria symptoms. However, no one becomes fully resistant to malaria, and partial immunity may disappear if you move to a country where you are no longer often exposed to the parasite.
Complications

Malaria can be fatal, especially malaria caused by a variety of parasites common in tropical parts of Africa. It is estimated that 91 percent of all malaria deaths occur in Africa – most commonly in children under 5 years of age.
In most cases, malaria deaths are associated with at least one serious complication, including:

  • Brain malaria
  • Breathing problems
  • Organ failure (kidney or liver damage or spleen rupture)
  • Anemia
  • Low blood sugar

Malaria prevention

There is no vaccine for malaria yet. Researchers around the world are trying to develop a safe and effective malaria vaccine, but there is currently no approved malaria vaccine for human use. The most powerful tool against malaria is prevention and prevention.
If you are going to travel to a place where malaria is common, talk to a tropical disease doctor a few weeks in advance whether you should take pills to protect yourself from malaria parasites. Basically, the drugs used to prevent malaria are the same drugs that are used to treat the disease. Your doctor must know when and where you will travel to help you assess the risk of infection and, if necessary, prescribe the drug that works best for the type of malaria parasite most common in this region.

malaria

If you live or travel to an area where malaria is common, take steps to avoid mosquito bites, especially in the dark. Mosquitos are most active from dusk to dawn. You should sleep under the mosquito net. Bed mosquito nets, especially insecticides, prevent mosquito bites while sleeping. To protect yourself from mosquito bites, you should also cover your skin with long pants and long-sleeved shirts. Use insect repellents on skin and clothing. DEET sprays can be applied to the skin, and permethrin sprays can be safely applied to clothing.

 

Diagnosing malaria

Seek medical attention immediately if you develop malaria symptoms during or after your visit to the place where the disease was detected.
You should still seek medical help, even if your symptoms occur a few weeks, months, or a year after returning from travel.

As malaria interventions have increased in sub-Saharan Africa over the past decade, rapid diagnostic tests for malaria have been made available in healthcare facilities, microscopes were provided, and microscopists were trained.
In 2010, the World Health Organization recommended that all suspected malaria cases be confirmed by a diagnostic test before starting treatment. The malaria withdrawal partnership has set new goals for universal access to malaria diagnostic tests in the public and private sectors as well as at the community level.

Diagnosis based on laboratory methods:

  • Microscopy
    Malaria parasites can be identified by examining a patient’s blood drop under a microscope. This drop is spread as a “blood smear” on a microscope slide. Before testing the slide, the blood sample is stained (most often with a Giemsa patch) to give the parasites a characteristic appearance. This technique is the gold standard for laboratory confirmation of malaria. However, this depends on the quality of the reagents, the quality of the microscope and the experience of the laboratory technician.
  • Quick diagnostic tests
    Over the past fifteen years, test kits have been made available to detect antigens derived from malaria parasites in human blood. These immunoassays (“immunochromatography”) are called RDT and provide results quickly – depending on the test, in about 20 minutes. RDT is a useful alternative to microscopy in situations where reliable microscopic diagnostics are not available. RDT malars are currently used in many clinical settings and programs in countries where malaria is transmitted. CDC and others conduct operational research to optimize their use. Unfortunately, tests may not confirm malaria.

 Malaria treatment

Malaria can be a life-threatening condition. Treatment of the disease depends on the type of malaria, as well as the severity of the disease, and is usually carried out in a hospital. The doctor prescribes medication depending on the type of parasite. In some cases, prescribed medications may not clear the infection because of the resistance of the parasites to the medications. If this happens, your doctor may need more than one medicine or change your medicine to treat your condition.

In addition, some types of malaria parasites, such as P. vivax and P. ovale, have liver stages in which the parasite can live in your body for a long time and reactivate later, causing the infection to come back. If it turns out that you have one of these types of malaria parasites, you will receive a second medicine to prevent relapse in the future.
Most of the drugs recommended treating uncomplicated cases of malaria in the endemic world of malaria work against forms of the parasite in the blood (the form that causes the disease). National malaria control programs for the endemic malaria world most commonly recommended and approved by medicines by the World Health Organization:

  • Combination therapy based on artemisinin (e.g. Artemether-lumefantrine, artesunate-amodiaquine)
  • Chloroquine *
  • Doxycycline
  • Mefloquine*
  • Quinine

Primaquine is used as an additive to some malaria species (e.g. P. falciparum, P. vivax and P. ovale).
Severe malaria is a medical emergency and should be treated urgently and aggressively.

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Before every trip to places at risk of malaria, we recommend that you consult with specialists. If you are unsure whether malaria is present in your area, WHO has current information.

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