Introduction
Malaria is one of the contemporary public health issues affecting approximately 40% of the world’s populace which amounts to 2.4 billion individuals. It is prevalent in tropical and subtropical countries across the globe. These countries are notably in Asia, Africa, Latin America, the islands of West, South and Central Pacific Ocean, Turkey and certain islands in the Caribbean. Most Malaria deaths and cases are, however, found in Sub-Saharan Africa according to World Health Organization. The World Health Organization also notes that in the year 2016 roughly 91 countries had ongoing malaria transmission (CDC, 2017). It is prudent to note that some populaces are at a higher risk of contracting malaria than others. These include pregnant women, HIV positive patients, children under five years of age and infants. Others include travelers, migrants, and mobile populations.
Disease Burden
The disease burden according to the 2017 World Malaria Report notes that globally there were “216million cases of malaria in 2016. This was up by 5 million in 2016 in comparison to the year 2015”. Additionally, the report notes that the number of malaria deaths stood at 445,000 in 2016 (CDC, 2017). The global malaria burden is disproportionately carried by the African region. This is largely tied to the fact that 90% of all cases and 915 of malaria deaths are associated with the region. WHO’s report continues to note that “some 15 countries-all in Sub-Saharan Africa, except India-accounted for 80% of the global malaria burden” (WHO, 2017). Notably, these areas that are deemed to have high transmission rates, more than two-thirds infections occur in the under-five age cohort (CDC, 2017). This is because the said cohort is the most susceptible to illness, infection, and death. However, due to elaborate anti-malarial campaigns, the deaths of the under-five’s have reduced by 35% from 2010 at 440,000 to 2016 at 285,000 (UNICEF, 2017). Statistics indicate that malaria claims a less than five years old child every two minutes.
Delegate your assignment to our experts and they will do the rest.
Transmission
The female Anopheles mosquito happens to be the primary carrier of the disease which is transmitted through bites. The mosquito introduces the Plasmodium parasite into a human being’s body as it feeds on blood. The prevalence of the disease is linked to the fact that there exist more than 400 different Anopheles mosquito species (UNICEF, 2017). It should be noted the transmission intensity is pegged on factors associated with the human host, the vector, the parasite, and the environment. Transmission is also intensified in places where the mosquitoes enjoy longer lifespan so that the Plasmodium parasite existing inside also has time to develop fully. The intensity is also noted where the insects prefer biting humans to other animals (UNICEF, 2017). In Africa, all these elements prevail explaining why nearly 90% of the global malaria cases are associated with the region.
Prevention
Public health agencies note vector control as the main way to counter and prevent malaria transmission. Communities are therefore encouraged to incorporate vector control interventions as part of their routine. WHO advocates for two forms of vector control. These include indoor residual spraying and use of insecticide-treated mosquito nets. The insecticide-treated mosquito nets have been central in many public health initiatives. The national governments in conjunction with non-governmental organizations and WHO, provide the long-lasting insecticidal nets or LLINs free of charge to the at-risk masses. The indoor spraying with residual insecticides, on the other hand, is encouraged with research and national agencies ensuring that available insecticides are in line with environmental concerns as well as the emerging issue of insecticide resistance (UNICEF, 2017). All the above intervention, however, to be effective must be backed by education which is achieved through public sensitization programs in places of worship, schools, seminars, community meetings et cetera. The public sensitization is deemed a very good initiative in that many people get to understand how malaria is transmitted and how best to counter the transmission. The basic knowledge contributes to reduced cases and deaths as a result of the disease.
Constraints
The main constraints faced by public health officials in different countries in the course of fighting malaria include the existence of resistance of insecticide and antimalarial drug resistance. This has been a setback for the anti-malaria initiatives at different levels. Research indicates that many pyrethroid insecticides are not effective in containing vectors (UNICEF, 2017). As such, the WHO and public health agencies encourage individuals to employ the rotational use of different insecticides. This is perceived as the most potent way managing insecticide resistance. Research points this problem to the reduced efficacy of LLINs in the high-malaria prevalent areas.
The resistance to the antimalarial medicines is also a notable setback in the fight against malaria. The P.falciparum is said to be resistant to the past generations of medicines such as sulfadoxine-pyrimethamine (SP) and chloroquine (WHO, 2017). This discovery was made in the 1950’s and 1960’s thereby hindering and undermining the control efforts and leading to increased child mortality. WHO, in light of this, has recommended that public health agencies monitor antimalarial drug resistance across different populations. The organization also strengthens individual countries in this endeavor. In recent years, WHO has established ACT drug continues to face parasitic resistance in the Greater Mekong sub-region (Lao’s People Democratic Republic, Cambodia, Thailand, Myanmar and Vietnam) (WHO, 2017). The artemisinin resistance has seen the organization focus on these countries to promote alternative malaria elimination programs.
There have been gains in the fight against malaria at the global level with the discovery of malaria vaccine which is currently being evaluated in controlled measures in the sub-Saharan African region. The pilot projects slated for 2018 have elicited excitement among public health units. It also complements the ambitious Global Technical Strategy for Malaria 2016-2030 by WHO (WHO, 2017). The strategy aims at promoting regional cooperation and programs aimed at controlling and eliminating malaria.
References
CDC. (2017, December 20). CDC - Malaria - Malaria Worldwide - Impact of Malaria. Retrieved from https://www.cdc.gov/malaria/malaria_worldwide/impact.html
UNICEF. (2017, December). Malaria - UNICEF DATA . Retrieved from https://data.unicef.org/topic/child-health/malaria/
WHO. (2017, November). Fact sheet about Malaria . Retrieved from http://www.who.int/mediacentre/factsheets/fs094/en/
