Malaria, called the “King of Diseases”, is one of the greatest health issues and represents a prime cause of increasing mortality in a variety of countries all over the world. The term Malaria has its origins from the Latin malus aria which means “bad air”. Originally, as early as the fifth century B.C., Hippocrates noticed the so-called fever in people who drank water from swamps. Later, it became evident that malaria is transmitted by infected mosquito bites. Nowadays, it is known that there are over 219 million cases and over 660 000 deaths in 2010. The majority of the infected populations live in the countries of the African continent. However, there are numerous cases identified in some regions of Asia and Latin America too. The World Health Assembly has the scope to reduce the occurrence of malaria and control its spread and death incidence by 75 percent in 2015. Aside from the huge toll that malaria takes on the lives and quality of life of the people suffering from it, there is also an astonishing economic impact of malaria. The disease excessively affects the low-income population on a larger scale since the presence of poverty contributes to the development of the parasite. Economically, it has been calculated that malaria decreases the GDP of the African continent by $12billion every year.
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Malaria represents an infectious disease that can be found in humans and animals as well. The disease is usually transmitted through a bite from any female infected Anopheles mosquito introduced into a person’s organism from the saliva. If a person gets infected with malaria, more complications may follow that may cause problems to the kidney, liver, and even the nervous system. The main parasite that causes malaria is called Plasmodia. Malaria stands on the fifth place in the world among the infectious diseases. The health problem of malaria occupies a significant place all over the world. From time to time, there are epidemics of malaria occurring in many geographical regions where the transmission has been liquidated. These types of outbursts are usually attributed to the aggravating social and economic circumstances, which are especially prevalent in the rural areas. Moreover, the lack of reliable health services associated with the administration of medicines without credible doctor’s presence lead to incomplete prevention and treatment of the disease.
The number one cause of malaria is the plasmodium parasite. There are many known kinds of the malaria parasite; however, only five of them present danger for humans. The five parasites that cause malaria in people are: plasmodium falciparum parasite, plasmodium vivax parasite, plasmodium ovale parasite, plasmodium malariae parasite, and plasmodium knowlesi parasite. Malaria can be spread through the bites of mosquitoes; however, it does not spread from person to person. Usually, malaria develops first in the liver after the person was bitten, and then it goes back into the bloodstream while attacking the red blood cells. The parasites multiply in the red blood cells, and the blood cells that have been infected will rupture at intervals of 48-72 hours. After the cells rupture, the individuals would experience high fevers or acute chills. The symptoms of malaria come and go in cycles; therefore, the best thing to do is to consult the doctor and get a blood test that checks for the existence of the malaria parasite in the blood. The symptoms of malaria carry a cyclical pattern because the malaria parasites exist in the following manner: they develop, reproduce and then travel into the red blood cells and to the liver as well. The time from the initial infection to the time that the symptoms become evident will range from 9 to 40 days depending on the type of the parasite; therefore, it is crucial to get tested at the early stage if you suspect that there is a chance you might be infected. The period of incubation may be higher if the individual is taking medicine to prevent the infection or if the person has higher immunity due to other infections in the past. Other specific symptoms of malaria include muscle pain, dry cough, joint pain, nausea and enlarged spleen. Malaria, in very exceptional cases, can cause brain malfunctions or spinal cord problems. Sweating and vomiting are also persistent and may last for up to a month (World Health Organization, 2013).
The main risk factors for getting infected with malaria are living or traveling in countries where malaria is spread, not taking medicine for preventing malaria in the event of traveling to the countries where the parasite is present, and not protecting oneself from mosquito bites. Other risk factors are dependent on the individual’s age and previous history of exposure to malaria. Young children and pregnant women are more prone to getting infected due to their lower immune system. Malaria is considered a medical emergency and must be treated with enormous attention and in a timely manner. A correct and rigorous diagnosis of malaria is vital for the effective treatment. The precise diagnosis of malaria includes the identification of the malaria parasites in the person’s blood stream. The delay in the diagnosis and treatment are among the most predominant causes of death in the majority of cases. The diagnosis and prevention of malaria directly depend on the level of education of the doctors and the available resources. There are three types of malaria diagnosis: the clinical method, the laboratory diagnosis, and the molecular diagnosis. The less expensive and most widely used method is the clinical method. This method of clinical diagnosis is based on the symptoms and physical examination of the patients. It is the simplest and fastest way of identifying the signs of malaria. The other two methods involve precise testing that is more effective in the long run; however, they are not available in all the regions affected by malaria. Undoubtedly, in the study of the malaria health problem, it is highly recommended to apply valid data and scholarly sources that will help to introduce valid information about this disease. It is widely known that African governments are trying to fight this illness; however, there are still many steps to pass. The difficulty of this situation is explained by the fact that the professional scientists, researches, and medical workers have built their theories of aiding African society on unreliable data. For example, national statistics of Africa have demonstrated invalid data of disease-specific morbidity and mortality data, causing political instability and speculations. To the most credible sources of this disease belong the following: World Health Organization, the Roll Back Malaria partnership, UNICEF, the US President's Malaria Initiative, International Medical Corps, and the World Bank; US, federal, state and local annual periodic reports. For example, the Global Fund has developed its own system of prevention, struggle against malaria, and application of effective treatment.
To the most vital reports based on the study of the malaria health problem belongs the World Malaria Report. Itcritically evaluates the achievements of malaria prevention achieved in 2012 and sets goals for 2015. Moreover, the recent reports of the Global Fund have demonstrated that the malaria health problem became an urgent issue in many countries since 2000. According to their results, the average level of deaths caused by malaria has decreased by 26 percent. With the help of global awareness, it is known that the number of malaria cases has dropped by 17 percent. Thus, the Global Fund asks developed countries to assist prevention coverage of malaria to all populations living in malaria endemic areas. In accordance with the recent reports of UNICEF, it is evident that this organization plays a pivotal role in struggling against malaria on regional, national, and global level. For example, UNICEF has shown that the rate of morbidity and mortality across all affected countries has significantly decreased, compared with previous years (2007-2012). Furthermore, the goals of malaria-related Millennium Development have been achieved. Additionally, thanks to persistent work of UNICEF, developed countries have applied universal coverage with effective interventions in order to prevent and treat patients with malaria (World Health Organization, 2013).
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According to the fact that depicts malaria death cases by age, it is clearly seen that the most risky group is females of 25-29 years old. If to take into account gender index, it is evident that female generation suffers from malaria more.
Unfortunately, reliable scientific sources have informed that approximately half of the world's population is at the edge of the malaria health problem. It is known that malaria seriously affects:
- young children whose immune system has not developed protection against malaria yet;
- pregnant women with non-immune system. Presence of malaria in their organisms can cause not only death of the future child, but also death of the woman;
- semi-immune pregnant women who live in highly transmitted areas. Consequently, malaria can deteriorate birth weight and can lead to miscarriage;
- semi-immune pregnant women who are also HIV-infected. Thus, HIV-infection can be transmitted to the newborns;
- generally, all people suffering from HIV and AIDS;
- foreigners and travelers from non-endemic areas. The problem is that they do not have developed immune system;
- immigrants from endemic locations whose children (are currently living in non-endemic areas) can be infected when they return home to visit their families and friends. This can happen since they do not have immune system (Weatherall, 2008).
Most malaria cases and deaths are geographically seen in the territories of sub-Saharan Africa, Asia, Middle East, and Latin America. According to the latest statistic results, there were recorded about 207 million cases of malaria in 2012. Among these results, it is evident that 627 000 patients died because of malaria. However, thanks to the global support and application of fully-fledged projects, it is known that malaria mortality rates have decreased by 42% globally since 2000, and by 49% in the territory of the WHO African Region. Furthermore, mortality level of children malaria has dropped by 54% since 2000. Moreover, it is estimated that not only African countries are in the high-level risk of malaria. Some territories of Europe are also affected, which is caused by global immigration and tight collaboration between countries. For example, it is seen in Greece. According to McElroy (2012), foreign affairs correspondent, it is known that the vast majority of Greek population was contracted abroad, but more than ten per cent were infected inside the country. The malaria health problem was recorded in seven regions across Greece.
Malaria varies globally in the level of intensity, in the transition and in the causes of this disease. It is known that malaria is widely spread in five regions, such as Africa, the American continents, Asia-Pacific, countries of Middle East, and Eurasia.
In the territory of Africa, there are approximately 50 countries with malarious areas. Forty-seven of these are mostly located in sub-Saharan African area. It is known that this territory is famous for being the most malarial location. According to statistics, ~694 million people are considered to be at high risk of malaria in these territories. The most affected African countries are the Democratic Republic of Congo and Nigeria. The second malaria-endemic region is the Americas. It is estimated that 22 American countries are at risk of malaria, especially, the territories located in Central America and around the Amazon Rainforest, in the Caribbean and in southern South America. Statistically, 137 million people live in risky territories. The third vulnerable region is Asia-Pacific where 22 countries are at risk of malaria. It is known that approximately 2.2 billion of Asians live in risky territories. The fourth malarial location is the Middle East (especially the territories of Iraq, Saudi Arabia, and Yemen). The fifth region of malaria is Eurasia (Afghanistan, Kyrgyzstan, Pakistan, Tajikistan, Turkmenistan, Uzbekistan, Armenia, Azerbaijan, Georgia, Turkey, and the Russian Federation). It is estimated that 270 million people are at risk of malaria (World Health Organization, 2013).
It is worth mentioning that malaria belongs to the diseases which may occur due to poor life conditions, lack of education, collapse of family life (that can lead to the deterioration of economical situation of the spouse), and inability of person to provide basic hygienic needs. If to take a look at its geographical spread, it is clearly seen that malaria and poverty are highly connected. Malaria is an urgent issue in those countries where income levels are low. These countries are underdeveloped and have a much deteriorated political system. Moreover, it is implicit that in the malaria-endemic countries, the life conditions, system of education and occupation is very poor and underdeveloped.
Temperature is a key determinant of malaria transmission. Recent scientific work has demonstrated that mosquito average temperature and the extent of the daily temperature significantly influence the life cycle of mosquito. Additionally, environmental changes highly influence malaria. For example, total monthly rainfall will precipitate the transmission of malaria. The most favorable seasons for malaria are summer and autumn since at those times humidity and warm temperature positively influence the incubation period of mosquitoes. In addition, rainfall plays a crucial role in the extension of malaria while it provides the aquatic favorable stage and the longevity of mosquito's life cycle. Scientists estimate that the following temporal variation significantly influences distribution of mosquito:
- Rise of water for larval breeding.
- Rise of temperature.
- Seasonal changes of mosquito populations.
- Suitable conditions for mosquito survival.
Undoubtedly, malaria highly depends on relationships between the mosquito vector, the host, surrounding, and parasite. Thus, these changes tremendously influence the extension of infection. In this case, measures of risk can be classified into two types, such as direct and indirect risk. In the direct measures of malaria, it is advisable to apply microscopic approach in the investigation of the relationship between denominators of malaria risks and the span of time that covers infection in organisms. In the indirect measures of malaria, it is recommended to apply available hand data and tools in order to assess danger of malaria. It is clearly seen that direct investigations of malaria are more detailed and precise.
Another vital factor to be mentioned in malaria epidemiology is division of malaria into two types, such as stable and unstable. Stable malaria is characterized by high prevalence, frequent occurrence of fever, causing anemia, especially in younger ages, and high level of mortality under 2. On the contrary, unstable malaria can occur in children of 4-6 years old. This type is typical for adults. Moreover, scientists point out that the most dangerous type of malaria is clinical malaria. This type can be characterized by such features as asymptomatic infections and periodic deterioration of human health (headache, diarrhea, muscle ache, and shivering). Clinical malaria is divided into three types, such as anemia malaria, cerebral malaria, and kidney failure malaria. Scientists have estimated that 30 % of infected people died because of this type of malaria. This can be explained by the fact that red blood cells transmit the infection. People who are suffering from this type of malaria can have anemia. The result of severe malaria can be lethal for patients. The second type of clinical malaria is cerebral malaria that can cause coma; the third type is kidney failure malaria that can cause high mortality.
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Undoubtedly, malaria belongs to the most leading causes of death worldwide. However, Hedrick (2012) claims that humans can resist this disease. This can be explained by the fact that people who live in malaria-endemic countries have quite developed immune system to struggle against this disease. For instance, P. falciparum is a variant of haemoglobin that helps to resist malaria. It is known that P. falciparum can be found in the territories of Africa and Asia. In contrast, in the New World, it is impossible to find this element since no case of malaria exposure was recorded there in the past.
All in all, malaria has become one of the most serious health problems in the 21st century. This disease can not only deteriorate human health, but itcan also lead to death. Thus, it is highly recommended to apply new technologies and modern medical breakthrough in order to save people from this disease.