Malaria

Malaria (Italian: "bad air"; formerly called ague or marsh fever in English) is an infectious disease which in humans causes about 350-500 million infections and approximately 1.3 million deaths annually, mainly in the tropics. Sub-Saharan Africa accounts for 85% of these fatalities.{{mn|OnePointThree|1}}

Disease control

Background

Efforts to eradicate malaria by eliminating mosquitos have been successful in some areas. Malaria was once common in the United States and southern Europe, but the draining of wetland breeding grounds and better sanitation, in conjunction with the monitoring and treatment of infected humans, eliminated it from affluent regions. Malaria was eliminated from the northern parts of the USA in the early twentieth century, and the use of the pesticide DDT during the 1950s eliminated it from the South. A major public health effort to eradicate malaria worldwide by selectively targeting mosquitos in areas where malaria was rampant was embarked upon in the 1950s and 1960s.{{mn|DDT|4}} However, these efforts ultimately failed to eradicate malaria in many parts of the developing world. The problem still most rampantly exists in Africa.

Related Topics:
United States - Europe - Pesticide - DDT - 1950s

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DDT was developed as the first of the modern insecticides early in World War II. It was initially used with great effect to combat mosquitoes spreading malaria. It was banned for use in many countries in the 1970s due to its negative environmental impact. There is great controversy regarding this impact and the use of DDT to fight human diseases. Some claim that the ban is responsible for malaria deaths counted in tens of millions in tropical countries where the disease had been under control.

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The World Bank estimates that malaria costs Africa $12bn a year in lost productivity. Yet international funding for malaria control is only $100m-$200m a year.{{mn|Funding|5}} It has been argued that in order to meet the Millennium Development Goals, money should be redirected from HIV/AIDS treatment to malaria prevention, which for the same amount of money would provide much greater benefit to African economies.{{mn|TwentyFive|6}}

Related Topics:
World Bank - Productivity - Millennium Development Goals - HIV - AIDS

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Conventional means

Since most of the deaths today occur in poor rural areas of Africa which lack proper health care, the distribution of mosquito nets impregnated with insecticide has been suggested as the most effective and cost-effective prevention method. These nets can often be obtained for less than US$10 or 10 euros when purchased in bulk from the United Nations or other organizations. The nets need to be re-impregnated with the chemical about every six months. Insecticide-treated bednets (ITN) have the advantage of protecting people living under the net and simultaneously killing mosquitoes which get in contact with the net and thus protecting people sleeping in the same room but not under the net.

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Spraying interior walls with DDT is also effective in areas where the mosquitoes are not already DDT-resistant. This public health use of small amounts of DDT is permitted under the Stockholm Convention on persistent organic pollutants (POPs), which prohibits the agricultural use of DDT for large-scale field spraying.{{mn|Permit|7}}

Related Topics:
Public health - Stockholm Convention

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Environmental management inculding elimination of mosquito habitats was an important measure to get rid of malaria in large parts of Europe. It is also an important option in many tropical (urban) settings.

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Vaccines and other new techniques

Vaccines for malaria are under development, with no completely effective vaccine yet available (as of September 2005). A team backed by the Gates Foundation and the pharma giant GlaxoSmithKline announced a partially successful field trial in October 2004, for RTS,S/AS02A, a vaccine which reduces infection risk by 30% and severity of infections by over 50%., although the numbers in this latter category of patients were rather small {{mn|Vacc|8}} Further research will delay this vaccine from commercial release until around 2010. In January 2005, Edinburgh University scientists announced the discovery of an antibody which protects against the disease. The scientists will lead a £17m European consortium of malaria researchers.{{mn|Vacc2|9}} It is hoped that the genome sequence of the most deadly agent of malaria, Plasmodium falciparum, which was completed in 2002, will provide targets for new drugs or vaccines. {{mn|Ghosh|10}}

Related Topics:
2005 - Gates Foundation - Pharma - GlaxoSmithKline - October - 2004 - RTS,S/AS02A - 2010 - Edinburgh University - Genome - 2002

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Sterile insect technique is emerging as a potential method to control malaria-carrying mosquitos. Progress towards transgenic, or genetically modified insects suggests that wild mosquito populations could be made malaria-resistant. Researchers at Imperial College London created the world's first transgenic malaria mosquito{{mn|Transgenic1|11}}, with the first plasmodium-resistant species announced by a team at Case Western Reserve University in Ohio in 2002{{mn|Transgenic2|12}}.

Related Topics:
Sterile insect technique - Genetically modified - Imperial College London - Case Western Reserve University - Ohio

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A very promising approach was announced in Science on June 10 2005. It uses inert spores of the fungus Beauveria bassiana to kill mosquitoes, sprayed on walls and bed nets. Unlike chemicals, mosquitoes have never been found to develop a resistance to fungal infections.{{mn|fungus|13}}

Related Topics:
''Science'' - June 10 - 2005 - Fungus - Beauveria bassiana

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