PROMOTING AWARENESS ON ENVIRONMENTAL SANITATION AS THE 2015 WORLD MALARIA DAY IS COMMEMORATED TODAY, SATURDAY APRIL 25
Malaria is a mosquito-borne
infectious disease of humans and other animals caused by a group of single-celled
parasitic micro-organisms known as protozoa belonging to the genus plasmodium.
The disease is mainly transmitted by mosquito bites, and the symptoms often
commence few days after the bite.
Malaria is transmitted most commonly by an infected female Anopheles
mosquito. The mosquito bite introduces the parasite called plasmodium from the
mosquito’s saliva into a person’s bloodstream. The parasites then travel to the
liver where they mature and reproduce.
The signs and symptoms of malaria
typically begin eight to twenty-five days following infection; however,
symptoms may occur later in those who have taken anti-malarial medications in
the past as prevention. Initial manifestations of the disease, which is common
to all malaria species, are similar to flu-like symptoms and can resemble other
conditions such as septicemia, gastroenteritis and viral diseases.
The presentation may include headache, fever, shivering, joint pain,
vomiting, haemolytic anaemia, jaundice, haemoglobin in the urine, retinal
damage, and convulsions. The classic symptom of malaria is paroxysm – a
cyclical occurrence of sudden coldness followed by shivering and then fever and
sweating; occurring every two days in P. Vivax and P. Malariae infection.
Severe malaria, which might lead to death, is usually caused by P. Falciparum
– often referred to as ‘Falciparum Malaria’. Its symptoms arise nine to thirty
days after contracting the infection. Individuals with cerebral malaria
frequently exhibit neurological symptoms including abnormal posturing,
nystagmus, conjugate gaze palsy i.e. failure of the eyes to turn together in the
same direction, opisthotonus, seizure, or coma.
There are several serious
complications of malaria. Among these is the development of respiratory
distress, which occurs in up to twenty-five percent (25%) of adults and forty
percent (40%) of children with severe P. Falciparum malaria. Possible causes
include respiratory compensation of metabolic acidosis, non-cardiogenic
pulmonary oedema, concomitant pneumonia and severe anaemia. It is worthy to
note that, concurrent infection of HIV with malaria increases mortality rate.
Malaria in pregnant women is the major cause of stillbirths, infant mortality,
abortion and low birth weight, particularly in P. Falciparum infection.
Symptoms of malaria can recur after varying symptom-free periods. Depending upon the cause, recurrence can be
classified as either recrudescence or relapse. Recrudescence is when symptoms
return after a symptom-free period; it is caused by parasites living in the
blood as a result of inadequate or ineffective treatment. Whilst, relapse is
when symptoms reappear after the parasites have been eliminated from blood but
persist as dormant hyponozoites in liver cells; relapse commonly occurs between
eight to twenty-four weeks and is common among P. Vivax and P. Ovale infections.
Malaria infection develops via two
major phases namely, one involving the liver known as exoerythrocytic phase,
and one that involves the red blood cells referred to as erythrocytic phase.
When an infected mosquito pierces a person’s skin to take a blood meal,
sporozoites in the mosquito’s saliva enter the bloodstream and migrate to the
liver where they infect hepatocytes, multiplying asexually and asymptomatically
for a period of eight to thirty days. After a potential dormant period in the liver,
these organisms differentiate to yield thousands of merozoites, which following
rupture of their host cells, escape into the blood and infect the red blood
cells to begin the erythrocytic stage of their life cycle.
The primary sources of mosquitoes
include sewage, refuse, dirty stagnant water, and untidy environment. In most
cases, mosquitoes are peculiar to damp and dirty environments or substances
such as gutter, pool, faeces, urine, among other solid and liquid waste
materials. This is why residents of untidy localities are at a high risk of
contracting malaria.
Methods used to prevent malaria
include medications, mosquito elimination through fumigation coupled with
regular environmental sanitation, as well as prevention of mosquito bites via
regular cum proper use of the mosquito nets, among others. Prevention of
malaria, which is yet to have a vaccine, may be more cost-effective than
treatment of the disease in the long run; though the initial costs required are
out of reach of many of the world’s poorest people.
Owing to the non-specific nature of
presentation of symptoms, diagnosis of malaria in non-endemic areas requires a
high degree of suspicion. Malaria is invariably confirmed by the microscopic
examination of blood films or by antigen-based Rapid Diagnostic Tests (RDT).
Microscopy is the most commonly used method to detect the malaria parasite in
the body. In spite of its widespread usage, diagnosis by microscopy suffers
from two main drawbacks: many settings especially rural are not equipped to
perform the test, and the accuracy of the results depends on both the skill of
the lab technician and the levels of the parasite in the blood.
Malaria is widely treated with
anti-malarial medications; the ones to be used solely depend on the type and
severity of the disease. While medications against fever are commonly used,
their effects on outcomes are not clear. Uncomplicated malaria may be treated with
oral medications; the most effective treatment for P. Falciparum infection is
the use of artemisinins in combination with other anti-malarial drugs known as
Artemisinin-Combination Therapy (ACT), which decreases resistance to any single
drug component.
It is obvious that malaria is a killer disease. The World Health
Organization (WHO) estimates that in 2010, there were about two hundred and
ninety (219) million cases of malaria outbreak resulting to six hundred and
sixty thousand (660,000) deaths. The majority of cases, about sixty-five
percent (65%), occur in children under fifteen years. Survey also indicates
that about one hundred and twenty-five (125) million pregnant women are at risk
of infection each year; in Sub-Saharan Africa such as Nigeria, Angola, Chad,
Congo, Benin, Ghana and several others, maternal malaria is associated with up
to two hundred thousand (200,000) estimated infant deaths yearly. In a
nutshell; globally, about 3.3 billion individuals in 106 countries are at risk
of malaria, mostly among African children.
Due to the widespread of malaria infection and its deadly consequence,
the World Health Organization thought it wise to proclaim World Malaria Day. In
view of this, in May 2007 during the sixtieth (60th) session of the
World Health Assembly, April 25 of every year was unanimously adopted as the
World Malaria Day. Needless to say; today the world over is commemorating the
World Malaria Day. The day was established to provide education and thorough
understanding of malaria disease across the globe, especially in countries
where the disease seems to be endemic.
As the annual World Malaria Day is being commemorated, I urge every
individual in Nigeria regardless of age or status, to be extremely conscious of
the outlook of his/her surroundings or immediate environment since malaria is
mainly attributed to unhealthy vicinity. Thus, we should always endeavour to
properly dispose any form of waste found within our place of residence as well
as thoroughly sanitize our gutters and toilets at all times. In addition, we
ought to ensure that our beds are always covered with treated mosquito net
whenever we lie in it.
Among all, we should endeavour to see our physician from time-to-time or
whenever we notice any abnormality in our body system, for onward review of our
health status. In the same vein, the various health workers/personnel across
the country are expected to contribute meaningfully and immensely in creation
of awareness regarding the causes and possible effects of malaria disease as
well as its epidemic. Above all, we ought to always bear in mind that
prevention is invariably better than cure. Think about it!
COMR FRED DOC
NWAOZOR
(The Media Ambassador)
_____________________________________
frednwaozor@gmail.com
+2348028608056