Information and stories about malaria.

Malaria in Sri Lanka
In the mid 20th century, Sri Lanka lied among the most malaria-stricken countries in the world. However, in September 2016, the World Health Organization (WHO) certified the successful elimination of malaria in Sri Lanka. A remarkable public health achievement, Sri Lanka is the second country in South East Asia to eliminate malaria (the Maldives being the first).

Eighty percent of Sri Lanka’s population lives in rural areas– the ideal environment for the mosquito species Anopheles culicifacies, the main vector of malaria in the region. The Plasmodium falciparum parasite causes the disease and is carried by Anopheles mosquitoes that feed on the blood of humans.

For seven decades, the country prioritized making the nation malaria-free. Malaria in Sri Lanka soared in the 1970s and 1980s, and the nation started an anti-malaria campaign in the 1990s. A strategy targeted the parasite in addition to the mosquito.

In 1991, the country’s number of cases of malaria reached up to 400,000. The country’s civil war put soldiers in the most vulnerable positions, with 115 people dying from malaria in 1998.

At the end of the war in 2009, Sri Lanka’s Minister of Health launched a malaria elimination program, funded in part by the Global Funds to Fight AIDS, Tuberculosis and Malaria. The campaign included mobile malaria clinics in high transmission areas with effective surveillance, community engagement and health education.

This program enhanced the ability of the authorities to respond. Ever since the implementation of this campaign, the introduction of high surveillance maintains the elimination of the parasite in Sri Lanka.

The eradication of malaria in Sri Lanka raised the hopes of 30 other nations to end the disease that kills 400,000 people every year. As the director of the WHO’s Global Malaria program stated, the island country demonstrated that any government can eliminate malaria with improved efforts.

Aishwarya Bansal

Photo: Flickr

Malaria Epidemic in Indonesia Women Fight
Global organizations have made significant strides in fighting the malaria epidemic in Indonesia by focusing on the health and welfare of pregnant women and children.

In an article published by IRIN, William Hawley, a malaria expert with the U.N. Children’s Fund (UNICEF), highlighted the importance of malaria treatment and prevention against the disease.

“Pregnant women and children are especially vulnerable to malaria, and modern malaria diagnosis and prevention can be delivered via existing maternal health and immunization services in a symbiotic way,” Hawley said.

World health organizations such as UNICEF have been working closely with Indonesian government agencies and world health programs to provide free and affordable care to women and children in the region.

“The malaria program, the antenatal care program, and the expanded program on immunization all benefit, but most important — women and kids benefit,” Hawley said.

According to the article by IRIN, nurses and midwives have been helping pregnant women and infants fight malaria by providing diagnosis, treatment and information regarding the disease. In response, more women have been provided antenatal care and more children have been immunized against malaria.

The Harsh Effects of the Malaria Epidemic in Indonesia

Malaria is a disease spread by mosquitoes causing symptoms including fever, exhaustion, vomiting, and headaches. Severe cases generally include yellowing of the skin, seizures, coma, or, in the most extreme instances, death.

The disease can be more dangerous to pregnant women and infants causing stillbirths, low birth weight, abortion and infant mortality. Malaria can also cause severe respiratory problems in both adults and children.

According to a report published by the World Health Organization (WHO), out of a population of close to 260 million, 190 million people were reportedly malaria free in 2015. This comes after a significant number of cases were reported between 2009 and 2012.

With the help of finances provided by the Global Fund, WHO, and UNICEF, residents of Indonesia have access to preventative measures against the disease in the form of mosquito nets, insect repellents, and insecticides. Residents are also taught the importance of mosquito control measures such as draining water to prevent reproduction.

According to a report by the CDC, with funding from UNICEF, USAID, the Gates Foundation and the Ministry of Health (MOH), many preventative programs have been integrated into immunization and prenatal care programs in five provinces in eastern Indonesia.

These organizations hope to expand to all areas where the disease continuously occurs to help fight the malaria epidemic in Indonesia.

Drew Hazzard

Photo: Flickr

Malaria — a disease caused by plasmodium parasites and transmitted by a mosquito bite — kills about 429,000 infected people every year. Though it can be treated easily for those who readily have access to healthcare, those who do not are often left to suffer. Unfortunately, sub-Saharan Africa is home to warm climates that attract the principal malaria mosquito, Anopheles gambiae. This leaves the citizens vulnerable to infection.

Malaria often cripples adults and children, forcing those infected to cease working or attending school. People disperse to less economically stable areas due to the fear of being infected; it even scares off potential investors and tourists. The money that the government and its citizens have to set aside for medical costs takes an enormous toll on the economic growth of the affected regions. Direct costs (illness, treatment, premature death) have been estimated to be at least $12 billion per year.

The U.S. recognized the devastating effects of malaria in Africa and decided to take action. In 2005, the Bush administration launched the President’s Malaria Initiative (PMI), which strives to reduce malaria-related mortality by 50 percent across sub-Saharan Africa.

At the end of April 2015, the PMI released its eleventh annual report to the U.S. Congress detailing the initiative strategy for 2015-2020. The report outlines how the President’s Malaria Initiative will work with national malaria control programs to accomplish the following by 2020:

  • Reduce malaria mortality by one-third, achieving more than 80 percent reduction from PMI’s original 2000 baseline levels.
  • Reduce malaria morbidity by 40 percent in PMI-supported countries.
  • Assist five PMI-supported countries to meet the World Health Organization’s criteria for national or sub-national pre-elimination.

To achieve these objectives, PMI will approach five areas:

  1. Mitigating risk against the current malaria control gains.
  2. Building capacity of health systems.
  3. Improving capacity to collect and use information.
  4. Sustaining scale of proven interventions.
  5. Adapting to epidemiology and incorporating new tools.

The PMI aims for the gradual eradication of malaria by 2040-2050. With the help and continued funding of the PMI, malaria will be on the road to eradication in sub-Saharan Africa — along with the social and economic losses caused by the disease.

Vicente Vera

Photo: Flickr

Among other diseases endemic to the region, malaria presents a constant danger in sub-Saharan Africa. While the disease continues to spread, new methods and technology are utilized to contain and treat it. Habiba Suleiman Sefu, a malaria surveillance officer, stands on the front lines of this fight on the archipelago of Zanzibar, off the coast of Tanzania.

Malaria is by far the deadliest disease known to mankind, killing more than 1,000 children a year. Most victims of the disease live in sub-Saharan Africa, in moist, humid regions where disease-carrying mosquitoes thrive. While the disease is not contagious, it is blood-borne and can spread quickly in areas with poor sanitation and standing water.

Historically, malaria in Zanzibar has been a constant danger, as it is the leading cause of death in mainland Africa. In 2000, malaria accounted for 30 to 50 percent of all hospital admissions and approximately half of all hospital deaths.

Sefu, 29, is an environmental science graduate and works as a malaria surveillance officer in the village of Shikani, in the southwest region of Zanzibar. Habiba tracks and treats malaria on the archipelago using her tablet, mobile phone and motorcycle, all supplied to her by the U.S. President’s Malaria Initiative (PMI).

When a case of malaria is reported at the local clinic in Shikani, Sefu receives an SMS message on her mobile phone. She then visits the family of the patient and tests them for the disease. If it is detected, she distributes medication and encourages affected individuals to go to the hospital.

In addition to treating malaria, Sefu educates families on the disease and makes certain that they are aware of contributing risk factors. She makes sure that families understand the importance of intact mosquito nets, insecticide, and the elimination of standing water, which provides a breeding ground for mosquitoes.

Sefu represents a new generation of disease control, utilizing new methods and technology to target malaria at its source and stop outbreaks before they begin. These new methods of malaria identification and treatment have yielded unprecedented results in fighting the disease. In fact, the prevalence of malaria in Zanzibar was reduced from 40 percent in 2005 to less than one percent in 2012. In addition, hospital admissions for malaria decreased to less than five percent in 2012, and no malaria-related deaths have been reported in Zanzibar since 2009.

While malaria has historically been a problem in sub-Saharan Africa, places like Zanzibar are making great strides towards eradicating the disease through the use of new technology and tracking methods. These methods have effectively eliminated malaria in Zanzibar, and with the use of surveillance officers like Sefu, malaria can be similarly eradicated on the African mainland.

Chasen Turk

Photo: Flickr

Diseases in Benin
Benin is a relatively stable democratic West African nation that lies between Togo and Nigeria. There are a number of diseases in Benin putting the health of its residents at serious risk. Malaria and meningococcal meningitis are among the top diseases in Benin. Both are potentially life-threatening for individuals who become infected.

The Fight Against Malaria

Malaria is a severe and life-threatening blood disease transmitted through the bite of the Anopheles mosquito. According to the Centers for Disease Control and Prevention (CDC), malaria is considered to be one of the high-risk diseases in Benin, affecting all areas of the country. As a result, it recommends that all potential travelers into the country get vaccinated prior to entering.

There are different mechanisms in place aimed at fighting against diseases in Benin. In 2005, the President’s Malaria Initiative (PMI) was created to help reduce the spread of malaria in particular. Researchers working in conjunction with PMI have found that malaria is currently the leading cause of health problems in Benin, and that it “accounts for 40 percent of outpatient consultations and 25 percent of all hospital admissions.” Consequently, families are forced to spend large amounts of money paying for treatments.

In response to this issue, PMI has been making progress in helping residents of Benin fight against malaria by providing residents with valuable resources such as trained healthcare workers, insecticide treatments, house-sprays and Rapid Diagnostic Tests. As of 2016, PMI has raised $155.2 million toward the effort.

The Fight Against Meningococcal Meningitis

In addition to malaria, meningococcal meningitis is another of the high-risk bacterial diseases in Benin. It is also common in other parts of sub-Saharan Africa.

Meningococcal meningitis causes inflammation of the brain and spinal cord. It is typically transferred via person-to-person contact. Some common symptoms associated with the disease are vomiting, headaches, neck stiffness and fever.

Furthermore, it has also been classified as one of the high-risk diseases in Benin, particularly during December through June. The CDC has recommended that persons traveling to the country during these months get vaccinated to help protect themselves from contracting the virus.

In response to this epidemic, the World Health Organization (WHO) has developed a strategy to help reduce the spread of meningococcal meningitis in Benin and surrounding countries. The WHO strategy consists of vaccinating everyone under 29 in the African meningitis belt with the MenA conjugate vaccine, and using “prompt and appropriate case management with reactive mass vaccination of populations not already protected through vaccination.”

Lael Pierce

Photo: Flickr

Toy Inspires Low-Cost Lab Aid to Detect Malaria
Malaria is a life-threatening disease caused by parasites that are transmitted through the bite of an infected mosquito. In 2015 alone, there were 212 million cases of malaria and 429 thousand deaths. Suffice it to say that malaria is a global health problem.

Even worse is that Sub-Saharan Africa continues to carry a disproportionately high share of the global malaria burden. In 2015, the region was home to 90 percent of malaria cases and 92 percent of malaria deaths.

The good thing is that malaria is preventable and curable, given the proper tools to do so. A device called a centrifuge that spins a blood sample very quickly and separates different cells can detect malaria. Centrifuges, though, are expensive, bulky and require electricity – which makes it inefficient in regions such as Sub-Saharan Africa.

A low-cost lab aid to detect malaria is in dire demand, which is exactly what Manu Prakash, a professor of bioengineering at Stanford University, realized on a trip to Uganda. On his trip, Prakash says he found centrifuges used as doorstops because there was no electricity.

Back in California, Prakash experimented with spinning toys in his search for a model for a low-cost lab aid to detect malaria. Though toys are not the conventional approach to developing a lab aid, Prakesh argues that toys hide profound physical phenomena we take for granted.

After experimenting with several spinning toys, including a yo-yo, they stumbled upon the children’s toy known as the whirligig or buzzer. The toy is made of a disk that spins when the strings that go through it are pulled.

This new low-cost lab aid to detect malaria dubbed the paperfuse, can separate pure plasma from whole blood in less than 1.5 minutes, and isolate malaria parasites in 15 minutes. The paperfuse has an ultra-low-cost of fewer than 20 cents, weighs only two grams and is, therefore, field-portable. The paper fuse could be the tool that helps detect and end malaria in low-income countries in the near future.

Mayan Derhy

Photo: Flickr

Five of the Top Diseases in Greece
Though often envisioned as an ideal vacation spot, home to thousands of sites, islands and beaches, Greece is not exempt from the list of countries affected by diseases, and it is necessary that travelers be aware of this.

  1. Coronary Heart Disease
    According to WHO, Coronary Heart Disease (CHD) is one of the top diseases in Greece, responsible for 26.17% of the country’s total deaths. Statistically, CHD occurs in men between the ages of 50 to 79, and in women ages 70-79. Controllable factors include arterial hypertension, diabetes, dyslipidemia, obesity, smoking and lack of physical activity. Non-modifiable factors include gender, age and family history of premature CHD.
  2. Stroke
    Falling second in the list of top diseases in Greece, mortality from heart disease and strokes has reached 35,000 deaths per year, which is high compared to other regions like Portugal or Spain. As a result, life expectancy for Greeks has fallen. Statistics showing 33% of adults smoking daily and 19.6% of the population being overweight or obese contribute to the issue.
  3. Malaria
    In 2011, a total of 20 cases of malaria occurred among Greek residents in the Evrotas, Laconia district, caused by the parasite Plasmodium vivax. The following year, 17 additional locally acquired cases were reported. According to the Centers for Disease Control, it is recommended that travelers take an anti-malarial medication and follow insect protection measures to reduce the risk of mosquito bites.
  4. Legionnaires’ disease
    A total of 14 cases of Legionnaires’ disease were reported on the island of Corfu in 2011. Legionnaires’ disease is a bacterial infection that typically causes pneumonia but can also involve other organ systems. The disease is usually transmitted through contaminated water sources, such as air conditioners and showers. Common symptoms include fever, cough, chest pain, difficulty breathing, headache, muscle pains and diarrhea.
  5. West Nile virus
    An outbreak of West Nile virus infections surfaced in 2010, causing 262 confirmed cases and 35 deaths. West Nile virus is carried by Culex mosquitoes. Most infections are mild but can affect the central nervous system, leading to fever, headache, confusion, lethargy, coma and in most serious cases, death. Because there is no treatment for West Nile virus, prevention methods should be taken by keeping cover and applying insect repellents.

For both locals and visitors, such recent outbreaks emphasize the importance of taking safety precautions and preventing further transmission of top diseases in Greece. Since most of these illnesses cannot be cured, undergoing certain treatment methods or making lifestyle changes help with recovery.

Mikaela Frigillana

Photo: Flickr

Elimination of Malaria by 2040: How Developing Countries Benefit
Malaria is a parasitic condition that is contracted primarily through the bite of an infectious Anopheles mosquito. Currently, sub-Saharan Africa suffers from the greatest disease burden of malaria as a consequence of widespread poverty and poor living conditions.

Malaria has serious social and economic implications. It is estimated that each year, Africa incurs a health care cost of $12 billion as a result of malaria. This cost imposes a significant strain on the continent’s financial resources. It also forces compromises to be made in other aspects such as a provision of schooling facilities and treatment of debilitating infections.

The elimination of malaria has always been an important but elusive objective of the global health care movement. Despite years of investment in research, no vaccine is currently available that offers complete protection against malaria. According to the World Health Organization, efforts are being focused on developing a clinically efficacious vaccine that protects against the most serious variant of malaria that is caused by the parasite Plasmodium falciparum.

Recently, the Bill and Melinda Gates Foundation, a humanitarian organization aimed at improving lives of the poor, has declared an ambitious objective: to eliminate malaria by the year 2040. The organization aims to achieve this goal through increased involvement of world leaders in the process of ending malaria. The foundation also aspires to involve countries afflicted with malaria in the movement by encouraging them to implement local strategies to tackle malaria.

The motive behind the movement is simply the fact that if malaria is not eliminated completely, countries could be tirelessly working toward the development of new vaccines, medications and prevention strategies to contain the spread of cases. This is not an economically viable solution for controlling malaria transmission — it represents a drain on valuable health care resources that can be used for the treatment of other life-threatening conditions such as cancer.

Increasing drug resistance of the organisms involved in the causation of malaria has limited the effectiveness of strategies targeted at the elimination of malaria. Currently, in Seattle, several research projects are experimenting with novel methods such as genetic modification to eliminate malaria.

With approximately 3.2 billion individuals globally estimated to be at risk of malaria, it is essential to control the spread of this disease. Malaria tends to be concentrated in regions of poverty, further exacerbating standards of living. As a result of the increasing connectivity of the world and the ease of access to different countries, travel has further increased the risk of spread of malaria to countries that are not typically affected by the condition.

The elimination of malaria by 2040 is a glorious yet difficult objective to achieve. Implementing pragmatic measures over the next few decades such as increasing awareness about malaria, improving sanitation and hygiene in poor countries, and prevention campaigns can bring us one step closer to the complete eradication of malaria.

Tanvi Ambulkar

Photo: Flickr

Malaria Eradication
Over the last decade and a half, the world’s fight for malaria eradication has yielded tangible results. According to the 2015 World Malaria Report, there has been a sharp decline in the global malaria incidence since 2000 with the malaria-related targets of the Millennium Development Goals (MDGs) achieved.

In 57 countries malaria cases reduced by 75%. In addition, the European region reported zero indigenous cases of malaria for the first time since the World Health Organization (WHO) began keeping track.

Globally, the number of malaria cases fell from an estimated 262 million in 2000 to 214 million in 2015, a decline of 18%; the number of deaths fell from an estimated 839,000 in 2000 to 438,000 in 2015, a decline of 48%.

Sadly, most cases and deaths in 2015 are estimated to have occurred in the WHO African region, 88 percent, followed by the WHO Southeast Asia region.

The overall numbers are encouraging. In the four decades before this, malaria eradication had almost slipped off the global health agenda despite a much-trumpeted Global Malaria Eradication Program in 1955.

While this campaign succeeded in eliminating malaria from Europe, North America, the Caribbean and parts of Asia and South-Central America it made no headway in sub-Saharan Africa. The program was abandoned in 1969 largely on account of the failure in tackling the technical challenges of executing any reasonable strategy in Africa.

Subsequently, the attention of the world shifted to other scourges like HIV. In small pockets research was being done on advances in drug and vaccine development, vector control and insecticide-treated nets, but little was achieved on the ground.

The latest numbers then, showing the real gains made in the battle against the disease particularly in Africa, are a welcome sign and owe much to initiatives by Civil Society Organizations (CSOs) such as non-governmental organizations (NGOs) and faith-based organizations (FBOs).

They bring much-needed technical as well as cultural expertise along with economies of scale to reach larger sections of populations in afflicted countries. Prominent among these are The Bill & Melinda Gates Foundation, Malaria Eradication Project (MEP) and the President’s Malaria Initiative (PMI).

In the fight against the killer disease, insecticide-treated mosquito nets (ITNs), indoor residual spraying (IRS), chemoprevention in pregnant women and children and treatment with artemisinin-based combination therapies (ACTs), have been the most effective methods.

Despite this tremendous progress, much more needs to be done to further reduce malaria’s burden. The Global Technical Strategy for Malaria 2016–2030 approved by the World Health Assembly in May 2015, set ambitious targets for 2030, including a reduction of at least 90% in global malaria incidence and mortality.

There are major challenges ahead. Decreases in malaria incidence and mortality have been slowest in countries that had the highest number of malaria cases and deaths in 2000.

As expected, malaria is concentrated in countries with weaker health systems and lower national incomes. In sub-Saharan Africa in 2014, some 269 million of the 834 million people at risk of malaria lived in households without nets or access to spraying.

In addition, the effectiveness of insecticide-based vector control is threatened as malaria mosquitoes develop resistance to the insecticides used in ITNs and IRS.

These are going to be the biggest hurdles in the way of eventually eliminating malaria from most parts of the world. However, with continued assistance from the global community, it seems likely that malaria will go the way of polio and smallpox over time.

Mallika Khanna

Photo: Flickr

Top Diseases in Ethiopia to Know About
Ethiopia is known as a historically prolific country that is endowed with abundant natural and agricultural resources. Yet, a list released by the U.N. detailing the least developed countries in the world declares Ethiopia as one of the poorest countries in the world.

Life expectancy in Ethiopia is estimated at 57 years for males and 60 years for females. These statistics indicate rudimentary health care infrastructure, but also lack of access to sanitation facilities, clean water and nutritious food. The list below explores the top diseases in Ethiopia that are a consequence of its geographical location, living standards and level of development.

  1. Neglected tropical diseases
    Neglected tropical diseases can be defined as a class of transmissible diseases that exist predominantly in tropical regions. These diseases are associated with delayed physical and mental development and blindness. Due to the incapacitating effects of these diseases, the true economic potential of underdeveloped countries is not realized.
    As a result of its proximity to the equator, Ethiopia bears the burden of neglected tropical diseases that include conditions such as trachoma and schistosomiasis. Trachoma is caused by a bacterial infection that primarily targets the eyes, causing irritation and in advanced stages, blindness. Schistosomiasis is a disease transmitted by parasites residing in freshwater snails. Its acute effects include itchiness of the skin or visible rashes.
    A 2012 study published in Parasites and Vectors estimated that approximately 5 million individuals out of 94 million individuals in Ethiopia are afflicted by schistosomiasis. Ethiopia’s widespread prevalence of neglected tropical diseases has important implications as these conditions often cause disability and can, therefore, reduce the potential to work.
    These diseases can be addressed by establishing local campaigns to distribute medicines, subsidies and donations by pharmaceutical companies and increasing awareness about the mechanisms of transmission.
  2. Malaria
    Although malaria is a worldwide phenomenon, its effects are particularly felt in countries that are not equipped with appropriate health care and education services. An article published in the Malaria Journal stated that countries such as Ethiopia are particularly predisposed to malaria as a consequence of poor living conditions and remote sources of clean water.
    It is estimated by the Ethiopian Federal Ministry of Health that each year, four to five million people in Ethiopia suffer from malaria, and even greater numbers are at risk. In order to address the vast numbers of malaria cases in Ethiopia, campaigns should be set up locally that provide clean water.
    The local population should also be educated on ways to keep their households clean, and in particular, avoid stagnant water, which is a potent breeding ground for parasites and mosquitoes. A humanitarian organization called Nothing but Nets has initiated the anti-malaria revolution by distributing millions of mosquito nets to families all across Sub-Saharan Africa.
    Statistics published by the World Health Organization postulate that 1.2 million people suffer from HIV/AIDS in Ethiopia. In addition, Centers for Disease Control and Prevention states that HIV infection is the third most common cause of death in Ethiopia, contributing to 7% of total deaths in the country. AIDS is an important cause of concern due to its manifold mechanisms of transmission. Children may risk contracting the viral infection if their mothers had the virus at the time of childbirth.
    AIDS prevention strategies should focus on raising awareness about the methods of transmission. Provisions should be made to subsidize preventive measures such as contraception and sterile needles.
  4. Rotaviral Diarrhea
    To provide context to the devastating effects of this variant of diarrhea, Dr. Adamasu Kesetebirhan, Minister of Health in Ethiopia states that, “Diarrhea takes the lives of more than 38,500 Ethiopian children under five each year, rotavirus being responsible for close to two-thirds of the deaths.” The virus spreads rapidly among children and is especially pernicious because of its ease of transmission.
    The rotavirus responsible for this type of diarrhea causes severe dehydration and fever. Currently, measures are being implemented throughout Ethiopia to distribute rotavirus vaccines in an attempt to reduce the prevalence of this condition.
  5. Hepatitis
    Hepatitis, another viral infection, is especially common in Ethiopia. Its methods of transmission include consuming contaminated water, living in unclean environments and eating poorly cooked meat. A recent statistic concerning viral hepatitis suggests that approximately 10 million individuals in Ethiopia are affected by the disease. Considering that transmission is greatly contingent upon hygiene and safety, clean practices such as washing hands regularly and chemical purification of water should be encouraged.

The above list outlining the top diseases in Ethiopia emphasizes the need to transform healthcare infrastructure and services in the country. Financial and food aid may be required from foreign countries to support the country during its initial stages of trying to reduce the prevalence of top diseases in Ethiopia.

Tanvi Ambulkar

Photo: Flickr