Malaria is the most widespread disease in the world, affecting some 300 million people in more than 90 different countries. It is also one of the best known and oldest. In relation to the latter, it is estimated that it has been infecting humans throughout its history, that is, more than 50.000 years.
The word malaria comes from medieval Italian and means "bad air", since it is associated with stagnant water, although the cause is the bite of a Anopheles mosquito infected, which injects parasites (called sporozoites) that travel to the liver through the blood. Once there, they mature and change shape, becoming merozoites, which return to the bloodstream and infect red blood cells. Despite all this, if when it is contracted, an urgent hospitalization is performed, the prognosis is good in most cases.
Understanding malaria transmission
The process of malaria transmission begins with the bite of a female mosquito of the genus AnophelesMosquitoes of this genus are the only ones capable of transmitting malaria because they are the only ones that ingest blood in the quantity necessary to allow the parasite to develop in their organism. Scientifically, it has been shown that the life cycle of the mosquito and environmental conditions play a crucial role in transmission.
The malaria symptoms they are chills, joint pain, headache, and vomiting. In severe cases, patients can suffer from jaundice, kidney failure, anemia, and even go into a coma.
Global impact of malaria
About 90 percent of all malaria cases worldwide occur in the tropics and sub-Saharan countries. The disease is particularly prevalent in India, Brazil, Afghanistan, Sri Lanka, Thailand, Indonesia, Vietnam, Cambodia and China. It is in these countries that the majority of malaria cases between 1 and XNUMX% occur. 1.5 million deaths annually that causes malaria.
Globally, efforts to combat malaria have intensified. According to WHO, in 2022, there were 249 million cases and 608,000 malaria-associated deaths in 85 countries. The impact of the COVID-19 pandemic added additional challenges that slowed control efforts in many countries. Despite these challenges, effective responses were maintained to prevent further loss of control.
Treatments and drug resistance
Malaria, while preventable and curable, has begun to face a serious challenge with increasing drug resistance. The main treatment for malaria is falciparum The most widely accepted drug is the artemisinin-based combination known as ACT. However, resistance to artemisinin has been detected in some regions, particularly in South-East Asia and Africa, which poses a major challenge for disease control.
Resistance to antimalarial drugs is not a new issue. Several generations of drugs, such as chloroquine and sulfadoxine-pyrimethamine, have become ineffective against some strains of parasites. That is why monitoring treatments is a priority for the WHO and other international health organizations.
Advances in malaria prevention
One of the main forms of protection against malaria is prevention of bites of the Anopheles mosquito. The use of insecticide-treated nets remains one of the most effective measures, especially in regions where malaria transmission is common. Mosquito repellents, protective clothing and indoor residual spraying with insecticides are also used.
The appearance of mosquitoes Anopheles Resistance to some insecticides has complicated prevention efforts. This has led to the use of mosquito nets combined with pyrethroids and piperonyl butoxide (PBO) that offer greater effectiveness. International organizations continue to search for new solutions to combat resistance.
The use of antimalarial vaccines is gaining prominence in efforts to eradicate malaria. Since October 2021, WHO has recommended the use of the RTS,S/AS01 vaccine in children living in areas with moderate or high transmission of the parasite. falciparumIn 2023, a new vaccine, R21/Matrix-M, was introduced, raising hopes for long-term control of the disease.
Monitoring and surveillance
Controlling malaria is not just a matter of effective treatments. Epidemiological surveillance, which includes the collection and analysis of data on cases and deaths, is essential. This allows countries to adapt their strategies to the realities of the disease in specific areas.
Programs such as the WHO's Global Technical Strategy for Malaria 2016-2030 aim to reduce malaria incidence and mortality by at least 90% by 2030. Surveillance can also identify new threats, such as drug resistance, changes in mosquito patterns and massive outbreaks.
Malaria and climate change
Climate change could have a significant impact on the distribution and transmission of malaria. Rising global temperatures, coupled with changes in rainfall and humidity patterns, are creating new areas susceptible to malaria transmission at higher altitudes, areas that were previously unaffected.
It is estimated that global warming could lead to an increase in the longevity of mosquitoes and an acceleration of the life cycle of the Plasmodium within the insect vector. As a result, malaria is expected to spread to new areas, affecting populations that are not prepared to combat the disease. It is essential that malaria control efforts consider these future risk scenarios.
Recent advances in diagnostic tools, improved treatments, new drugs in development and the promise of effective vaccination have renewed hope in the fight against malaria. However, surveillance, prevention and control efforts must continue to prevent malaria from taking further lives. The combination of scientific research, access to timely treatments and international cooperation will be key to eradicating malaria in the coming decades.