Scientists are working round the clock to the rid the world of this disease – but perhaps the solutions are closer home than we think
In the year 1630, whilst visiting Peru, the Viceroy’s wife theCountess de Chincon fell ill.
She developed headaches, nausea, and finally, a fever. Her health deteriorated so badly it was feared she might die. In a last, desperate attempt to save her, the local Indians bathed her in a nearby pond, one that was believed to have healing qualities.The Countess miraculously survived and the Jesuit priests who were tending to her experienced firsthand the magical qualities of the bark of the trees that surrounded the pond.
The mysterious substance that had transferred from the bark into the water and cured the Countess was named “Jesuit’s bark” when she returned to her native Spain. Now we know it was quinine, and that what the Countess had been suffering was malaria.
The Italians gave us the modern name we use for this disease: mala aria, which means ‘bad air’.This is because early physicians thought that the illness was spread via the air emitting from swampy grasslands. The English called it ‘marsh fever’.Both were correct; we now know that the favoured habitat of the mosquito is marshy areas.
History books are littered with references to malaria. Quinine was not the only ancient cure for it. The other, Artemesia, is a herb and was first mentioned in a 2nd Century text called the 52Remedies. It was discovered when a Chinese tomb was opened. Both are still in use today.
So why is it that the pharmaceutical industry can’t develop what must surely be a simple vaccine for this disease? Why does one child a day still die from malaria in Africa, and what is being done to stop this?
Malaria is not a virus; it is a parasitic disease transmitted by the female of the Anopheles species of mosquito, which infects humans or livestock by the transference of mucus while feeding on their blood. Contained within that mucus are single-celled organisms called parasites that deliver the actual virus. There are four parasites: Plasmodium falciparum, Plasmodium vivax, Plasmodium malaria and Plasmodium ovale. Plasmodium falciparum is the most dangerous, causing a far higher percentage of deaths.
Here in Africa, we have the toughest females of all species. The local species of Anopheles mosquito lives longer, allowing the parasite to develop fully in the mosquito. The local female Anopheles also habitually bites humans more than livestock.
That said, malaria is not a global worry anymore.Malaria has been eradicated in many parts of Europe. The last major outbreak was after the FirstWorld War when huge areas of previous battlefields were full of stagnant surface water containing this new and deadly foe. Removing the stagnant water and giving the people access to government distributed quinine alleviated the issue. A continual focus on improving medical services has managed to contain the disease in Europe, and the disease has only surfaced in Mediterranean coastal areas since then.
After the Second World War, huge areas of both Europe and the US were sprayed with a chemical that has been the subject of much controversy, DDT, which killed all the mosquitoes and therefore effectively eradicated malaria. Even though theWorld Health Organisation endorsed its use in2006, there have been warnings against it. The medical science publication Scientific American states that according to scientists, “… DDT may have a variety of human health effects, including reduced fertility, genital birth defects, breast cancer, diabetes and damage to developing brains.Its metabolite, DDE, can block male hormones.”And so it is a trade-off between malaria and the side effects of DDT. This chemical was banned in the US due to concerns it had worked its way into the food chain and was responsible for the reduced numbers of pelicans and bald eagles, the national bird. Significantly, the programme there had seen the chemical sprayed directly onto crops, not directly in the homes of people like we do herein Africa. There are just under 1 million deaths globally a year from malaria; 90 percent of these are in Africa, so it is justifiable that we should take control of the use of DDT.
Let’s go back to our earlier question: Is the pharmaceutical industry working on a vaccine to counter this disease? The answer is yes – but it is a devilishly complex process. Just like a sci-fi bug, the malaria virus is able to mutate and keep one step ahead of the people trying to find a way to eradicate it. Human malaria differs from animal malaria, so any tests on animals will not reflect results on humans.
The most promising prospect is from UK firm GlaxoSmithKline, who have been working on the drug RTS, S for many years. They implementedAfrica’s largest ever clinical trial, involving 15, 500children. The results were positive, but not perfect.The drug displayed an effectiveness of 46 percent for children aged between five and 17 months, but only 27 percent effectiveness for those aged six to 12 weeks. GSK are now seeking European medicine Agency approval to move to the next stage and make this drug available.
One of the biggest concerns is that we actually have many of the tools to stop the continual march of malaria already, but that because we are all waiting for the magic bullet we let slip these other key frontline preventions. These have worked, as we’ve seen most deaths from malaria occur in Africa, but malaria mortality rates among children in Africa have been reduced by an estimated 58 percent since 2000. These are the simple, affordable steps to take against malaria, as advised by EastAfrican Community Health Sector:
Sleeping under nets reduces contact with the mosquitoes – and reduces the chances of infection even further if the nets are treated with insecticides that will kill the mosquito before she can find a hole.
Prior to the use of chemicals, especially DDT, the effective destruction or poisoning of mosquito breeding grounds was a successful way to prevent the spread of the disease.Applying oil to unused standing water is one such means. Otherwise, cover water tanks, especially in urban areas.
Indoor Residual Spraying
Indoor residual spraying (IRS) sprays insecticides onto the interior walls of homes in malaria-prone areas. After biting and feeding, mosquito species then rest on nearby surfaces to digest blood. When the walls are coated with insecticides, the mosquitos are killed prior to passing the parasite on.
Recognise the Symptoms
Getting medical assistance in the early stages is key, so learn the symptoms of malaria. Moderate to severe shaking chills, high fever, profuse sweating, headache, nausea, vomiting, diarrhea, and anemia are all signs one should pay attention to.If we continue to use the tools developed we can all look forward to a malaria-free future.