World Malaria Challenge!!!

Each year Peace Corps Uganda dedicates April to working on malaria awareness. April is World Malaria Month. World Malaria Day is April 25. This year, PC UG is working on it for six weeks, from March 23 to May 16, encouraging all PCVs, whether they're in Health, Education, or Agribusiness.

The top ten facts about malaria as determined by WHO (World Health Organization):1

  1. Malaria is caused by parasites that are transmitted to people through the bite of infected mosquitoes. Malaria is caused by Plasmodium parasites that are spread to people through the bites of infectedAnopheles mosquito vectors. Of the 5 parasite species that cause malaria in humans, Plasmodium falciparum is the most deadly.
  2. Half of the world’s population is at risk of malaria, about 3.2 billion people.
  3. Every minute, a child dies from malaria. Most of them are under five.
  4. Malaria mortality rates are falling, 47% globally and 54% in the Africa region from 2000 - 2013.
  5. Early diagnosis and prompt treatment of malaria prevents deaths.
  6. Emerging artemisinin resistance is a major concern.  Artemisinin is the core compound in WHO-recommended treatments for uncomplicated malaria. Resistance has been found in South East Asia.
  7. Sleeping under long-lasting insecticidal nets (LLINs) protects against malaria. These can be effective for 3-5 years.
  8. Indoor residual spraying of insecticides is the most effective way to rapidly reduce malaria transmission. This is effective for 3-6 months at killing the mosquito vector.
  9. Pregnant women are particularly at risk of malaria. It can cause abortion, premature delivery, stillbirth, and severe maternal anaemia. WHO recommends intermittent preventive treatment (IPTp).
  10. Malaria causes significant economic losses in high-burden countries.

When you hear the word “malaria”, you probably think of Africa immediately. You’d be right to. In 2013, there were 198 million cases of malaria, and 584,000 deaths. 90% of all deaths were in Africa, and were mostly children under five.2 But it wasn’t so long ago that malaria was somewhere more familiar. Malaria was a big problem in America until the 1950s. Check out the following graphics from the CDC.3

Distribution of malaria in the United States, 1882-1935. (Report for Certification and Registration of Malaria Eradication from United States of America published by PAHO/WHO, December 1969)

Malaria Morbidity and Mortality Rates in All States Reporting Cases and Deaths During 1920-1946 Inclusive

Before the CDC (Centers for Disease Control) was the CDC, it was the Office of Malaria Control in War Areas, started in 1942. Malaria was most problematic in the South, and the focus was on military bases.

From the CDC’s website:
 “The National Malaria Eradication Program was a cooperative undertaking by state and local health agencies of 13 southeastern states and the Communicable Disease Center of the U. S. Public Health Service, originally proposed by Dr. L. L. Williams. The program commenced operations on July 1, 1947. It consisted primarily of DDT application to the interior surfaces of rural homes or entire premises in counties where malaria was reported to have been prevalent in recent years. By the end of 1949, more than 4,650,000 house spray applications had been made. It also included drainage, removal of mosquito breeding sites, and spraying (occasionally from aircrafts) of insecticides. Total elimination of transmission was slowly achieved. In 1949, the country was declared free of malaria as a significant public health problem. By 1951, CDC gradually withdrew from active participation in the operational phases of the program and shifted its interest to surveillance, and in 1952, CDC participation in operations ceased altogether.”

Eradication has since come to mean the absence of malaria worldwide, while elimination now means the absence of malaria in a certain geographic area. What do these stats mean for Africa? It’s possible to get rid of malaria! We are making good progress, but we’re not there yet.. In 2013, only half of the at risk population (children, the elderly, pregnant women) had access to mosquito nets. There is still work to be done!

USAID (United States Agency for International Development) works on four major areas:4
  • Indoor residual spraying (IRS): IRS is the organized, timely spraying of an insecticide on the inside walls of houses or dwellings. It kills adult mosquitoes before they can transmit malaria parasites to another person.
  • Insecticide treated mosquito nets (ITNs): An insecticidetreated mosquito net hung over sleeping areas protects those sleeping under it by repelling mosquitoes and killing those that land on it.
  • Intermittent preventive treatment for pregnant women (IPTp): Approximately 125 million pregnant women annually are at risk of contracting malaria. IPTp involves the administration of at least two doses of an antimalarial drug to a pregnant woman, which protects her against maternal anemia and reduces the likelihood of low birth weight and perinatal death.
  • Diagnosis and treatment with lifesaving drugs: Effective case management entails diagnostic testing for malaria to ensure that all patients with malaria are properly identified and receive a quality assured artemisinin based combination therapy (ACT).

There are also numerous organizations providing nets and training on how to use them. These include:

Against Malaria Foundation (AMF)

Malaria No More

Nothing But Nets

  1. http://www.who.int/features/factfiles/malaria/malaria_facts/en/
  2. www.worldmalariaday.org
  3. Elimination of Malaria in the United States (1947 – 1951) http://www.cdc.gov/malaria/about/history/elimination_us.html
  4. http://www.usaid.gov/what-we-do/global-health/malaria