COMMEMORATING THE 2017 WORLD MALARIA DAY
The last time I checked, April 25 of each year
remained the World malaria Day. This implies that tomorrow being Tuesday,
Imolites will join the global community to mark the 2017 edition of the
commemoration. Owing 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. 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.
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.
As Imolites, and Nigerians in
general, join the rest of the world to commemorate the annual World Malaria
Day, I enjoin each of everyone of us regardless of age or status, to be
extremely conscious of the outlook of his/her surroundings 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
should ensure that our beds are always covered with treated mosquito net
whenever we lie in it.
We should equally 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. Similarly, the various
health workers/personnel across the state and beyond are expected to contribute
meaningfully in creation of awareness regarding the causes and possible effects
of malaria disease as well as its epidemic. We ought to always bear in mind
that prevention is invariably better than cure. Think about it!
FDN Nwaozor
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http://facebook.com/fred4nwaozor
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