Mosquitoes and Malaria: A Deadly Combination
In many countries that The Odyssey travels, we must take precautions against one of the world's most complex and serious health problems: malaria. Reports show that the global malaria situation is serious and becoming worse. In 1997 over 40% of the world population lived in areas with malaria risk. Overall, the situation has not changed and global estimates remain the same with the incidence of malaria in the world at 300-500 million clinical cases annually. Some 1.5-2.7 million people die of malaria each year, and approximately one million deaths among children under five years of age are attributed to malaria alone or in combination with other diseases. Countries in tropical Africa account for more than 90% of the total malaria incidence and the great majority of malaria deaths.
Malaria is caused by a parasite that is transmitted from person to person by the bite of an infected Anopheles mosquito. Previously extremely widespread, these mosquitoes are now mainly confined to the poorer tropical areas of Africa, Asia and Latin America. Anopheles mosquitoes bite during nighttime hours, from dusk to dawn.
Plasmodium falciparum is the predominant malaria parasite in tropical Africa, the Amazon area, Southeast Asia, and Oceania. It is the main cause of severe clinical malaria and mortality, striking young children, non-immune adults, and women during their first pregnancies. You might wonder why malaria doesn't infect everyone in these countries. In countries where transmission is high, people are continuously infected so that some gradually develop immunity to the disease. The problems of controlling malaria in these countries are aggravated by inadequate health structures and poor socioeconomic conditions. The situation has become even more complex over the last few years with the increase in resistance to the drugs normally used to combat the parasite that causes the disease.
Political commitment on a long-term basis is required to make the changes necessary to implement technical programs effectively. Recent years have seen a welcome political effort by endemic countries and donor countries alike to make malaria control a priority on the health agenda. In 1997, Heads of State and Government of 53 countries adopted the Harare Declaration on Malaria Prevention and Control in the Context of African Economic Recovery and Development, committing their countries to a renewed effort to control malaria.
How does someone know if they have malaria? Symptoms of malaria include fever, chills, headache, stiff joints, and sometimes vomiting, diarrhea, and/or coughing. The early stages of malaria may be confused with the onset of the flu. If you've been travelling in a malaria risk country and find yourself with a fever during or after travel, you should get immediate medical attention and should inform your doctor of your recent travels. The symptoms will quickly disappear once the parasite is killed through treatment.
This disease wasn't defined as malaria until the discovery of the parasite by Laveran in 1880 (for which he was awarded the Nobel Prize for medicine in 1907), and the demonstration by Ross in 1897 that the mosquito was the vector of malaria. Protective measures against the mosquito bite have been used for many hundreds of years, although before the Laveran discovery people were unaware of the origin of the recurring fevers or how the fevers were transmitted. As far back as 485 BC. Herodotus noted that in the swampy region of Egypt, some people slept in tower-like structures out of the reach of the mosquitoes, whereas others slept under nets.
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One of the first insecticides used to control malaria was the powerful DDT, with effective and inexpensive anti-malarial drugs of the chloroquine group following shortly afterward. Unfortunately DDT was found to be highly toxic to humans and neighboring animal residents. A good example of DDT's danger can be seen in the near extinction of the California Condor. Due to DDT use in California, condor eggs became defective. Their shells were too thin to protect the condor young from the weight of their parents during incubation and were crushed. The use of DDT has been banned in the United States and there is currently an effort to have it banned worldwide.
We World Trekkers, as well as other travelers, can still get malaria, despite use of prevention measures. No vaccine against malaria is available, but we have learned to protect ourselves by using anti-mosquito measures and by taking drugs to prevent the disease. Malaria symptoms can develop as early as 6-8 days after being bitten by an infected mosquito or as late as several months after departure from a malaria-risk area, after anti-malarial drugs are discontinued. If malaria is caught in the early stages, it can be treated, but delaying treatment can have serious consequences. We have learned about the most effective ways to avoid getting bitten by the infected mosquitoes although it's sometimes hard to follow all the precautions. See the sidebar for some of the techniques we've used to steer clear of malaria.
Here are a few techniques we've learned to help avoid the dreaded malaria disease:
- Take malaria pills
- Remain in well-screened areas between dusk and dawn
- Use mosquito nets
- Wear clothes that cover most of the body
- Use insect repellent on any exposed areas of the skin
- Purchase a flying insect-killing spray to use in living and sleeping areas during the evening and night
We have all been lucky enough to avoid being bitten by a malaria mosquito so far, although one of our new Malian friends, Dabel, was recently infected. Keep your fingers crossed that our good luck will continue and we'll do our best to steer clear of the nasty critters!
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