“An Italian walk’s into a country……” sounds like the start of a bad joke. When the ancient Romans named the disease plaguing their mighty army malaria (‘bad air’ in Medieval Italian), they definitely did not know that it would one day have an annual economic impact to Africa of $12 billion every year. The name was derived from the association of the disease with swampy, marshy areas where the air smelled bad. Malaria occupies a unique place in the annals of history.
Over millennia, its victims have included Neolithic dwellers, early Chinese and Greeks, princes and paupers. In the 20th century alone, this weapon of mass destruction claimed between 150 million and 300 million lives, accounting for 2 to 5 per cent of all deaths.
Malaria is a serious and sometimes life-threatening tropical disease that spreads through parasites. A mosquito’s bite transmits a parasite into a person’s blood, where it infects red blood cells. Periodically, the red blood cells rupture, causing fever, chills, flu-like symptoms and organ damage that can prove fatal if not treated quickly. The disease is caused by Plasmodium parasites, which are carried by Anopheles mosquitoes.
Only female mosquitoes spread malaria parasites. When a mosquito bites a person who already has malaria, it sucks up the person’s blood, which contains the parasites. When the mosquito bites its next victim, it injects the parasites into that person thus spreading the disease.
Once the parasites enter the body, they travel to the liver where they multiply. They then invade red blood cells, which are important cells in the blood that carries oxygen. The parasites get inside them, lay their eggs, and multiply until the red blood cell bursts.
This releases more parasites into the bloodstream. As they attack healthier red blood cells, this infection can make one feel very sick.
Symptoms for malaria usually start about 10 to 15 days after the infected mosquito bite. There are some things to keep in mind, though:
- Because the signs are so similar to cold or flu symptoms, it might be hard to tell what a client is suffering from at first.
- Malaria symptoms don’t always show up within 2 weeks, especially if it’s a P. vivax infection.
- People who live in areas with lots of malaria cases may become partially immune after being exposed to it throughout their lives.
A blood test can confirm whether you have malaria. Along with high fever, shaking chills and sweating, symptoms can include:
- Nausea and Vomiting
- Body aches
- Yellow skin (jaundice) from losing red blood cells
- Kidney failure
A person with severe malaria may get anaemia, a condition that happens when one loses too many red blood cells. They may also have trouble breathing. In rare cases, they can get cerebral malaria, which causes brain damage from swelling.
Malaria is treated with prescription drugs to kill the parasite. The types of drugs and the length of varies, depending on:
- Type of malaria parasite you have
- The severity of your symptoms
- Pregnancy state
The most common antimalarial drugs include:
- Artemisinin-based combination therapies (ACTs). ACTs are, in many cases, the first line treatment for malaria. There are several different types of ACTs. Examples include artemether-lumefantrine (Coartem) and artesunate-amodiaquine. Each ACT is a combination of two or more drugs that work against the malaria parasite in different ways.
Other common antimalarial drugs include:
- Combination of atovaquone and proguanil (Malarone)
- Quinine sulfate (Qualaquin) with doxycycline (Vibramycin, Monodox, others)
- Primaquine phosphate
The World Health Organization (WHO) estimates that 3.2 billion people are at risk of malaria worldwide. Sub-Saharan Africa is disproportionally affected; in 2015, the region had 88 per cent of malaria cases and 90 per cent of malaria deaths (WHO 2016).
In Kenya, malaria remains a major cause of morbidity and mortality with more than 70 per cent of the population at risk of the disease with roughly 34,000 young children dying of malaria-related causes annually. High transmission cases usually coincide with the rainy season. Indeed, the current delays in rains have seen a sharp decline in clients diagnosed with Malaria. According to 2009 statistics, malaria constituted approximately 32% of the total outpatient cases in Nyanza and Western provinces in Kenya.
Malaria is also terrible for business: this ‘bad air’ can strain national economies, impacting some nations’ gross domestic product at an estimated 5–6%. It is responsible for employee absenteeism, increased health care spending, and decreased productivity, all of which can negatively impact a company’s reputation. In some areas, malaria accounts for 15% of health-related absenteeism from school. It is estimated that in endemic areas, malaria may impair as much as 60% of the school children’s learning ability.
A 2011 Roll Back Malaria report found that in sub-Saharan Africa, 72% of companies reported a negative malaria impact, with 39% perceiving these impacts to be serious. Leading economists estimate that malaria causes an “economic growth penalty” of up to 1.3% per year in malaria-endemic African countries. Malaria discourages investments and tourism, affects land use patterns and crop selection resulting in sub-optimal agricultural production, reduces labour productivity, and impairs learning.
In a 2004 survey, nearly three-quarters of companies in the Africa region reported that malaria was negatively affecting their business. Poor women and children in rural areas are at the greatest risk of death or severe debility from malaria, which drains the resources of families. Overall, households in Africa lose up to 25% of income to the disease.
The impact of this annihilator is huge. It’s time we end Malaria for good.