Malaria Pop & Env case study

What are ACT’s?

Combining a range of drugs used to treat malaria in order to increase effectiveness and attack the malaria parasite.

How many countries have introduced ACT’s to combat malaria?

79/88 countries affected by malaria.

What percentage of malaria cases are in Africa?

90%

How many deaths are caused by malaria a year?

Around 600,000

What percentage of malaria deaths are in Africa annually?

Around 95% with around 570,000

What is a growing problem with the use of ACT’s?

In South East Asia resistance to ACTs has emerged from malaria parasites, raising concerns on how the disease will be treated if this becomes commonplace.

Where are most countries impacted by malaria and what are the most impacted?

Nigeria is the most affected country with 68.5 million cases followed by the DRC at 33 million cases (2024 for both). Globally there was 282 million cases of malaria in 2024.

What is a vector?

An organism (such as an insect) that transmits a pathogen from one organism or source to another.

What are communicable diseases?

A disease that is transmissible by contact with infected individuals or their bodily dischargers or fluids, by contact with contaminated surfaces or objects, by ingestion of contaminated food or water, or by direct or indirect contact with disease vectors.

What is an epidemic?

An outbreak of a disease that occurs over a wide geographic area (such as multiple countries or continents) and typically affects a significant proportion of the population.

What is an endemic?

A disease that is restricted or particular to a locality or region.

What is a pandemic?

An outbreak of disease that spreads quickly and affects many individuals at the same time.

How is mitigation used to stop the spread of malaria?

The aim of this is to slow the disease, and to reduce the peak in health care demand. This may include policy actions such as social distancing, including a full society lockdown, and improved personal hygiene or draining mosquito swamps.

When and how was malaria brought to the Americas?

16th century at the start of the slave trade.

When did the WHO launch the global eradication programme and what was the issue?

1955 and the parasite became increasingly resistant.

When did the WHO launch the new treatment of ACTs.

2001

What were the dates and stages in developing a cure for malaria?

• 1630- Don Francisco Lopez discovers that the bark of the cinchona tree can help cure malaria.

• 1820- Pelletier and Caventou start to develop a cure by isolating the quinine molecule from cinchona bark.

• 1880- Alphonse Laveran observes falciparum in patients’ red blood cells under a microscope.

• 1897- Ronald Ross discovers the anopheles mosquito, which transmits the malaria parasite to humans.

• 1940- Chloroquine and other synthetic antimalarials are now being used.

How is malaria transmitted to humans?

The anopheles mosquito acts as a vector transmitting the malaria parasite to humans.

What has happened to malaria deaths?

They have fallen across all ages and both sexes from around 840,000 in 2000 to 610,000 in 2024 according to the WHO alongside a population increase of 830 million to 1.5 billion.

Why did malaria deaths decrease?

This is because of the developments of ACTs in 2001 and increased use of insecticides to kill mosquitos, nets to prevent bites and making mosquitoes infertile.

What is the issue of insecticides and draining wetlands?

This leads to wide scale environmental damage for eco-systems and can leak into water sources which people drink from and use for agriculture leading to health issues for civilians.

What is the process of the anopheles mosquito transmitting malaria?

• The female anopheles bites at night to feed on human blood and if its victim is already infected, the mosquito sucks in not only blood but numerous parasites.

• Once in the mosquitos guts the parasites multiply, divide and then move to the salivary glands, and when it bites again, the parasite invades the next victim’s blood.

What parasite causes malaria?

Plasmodium parasites

What is a parasite?

A parasite is an organism that lives on or in a host organism, deriving nutrients or other benefits at the host's expense, causing harm (like disease or weakness) without immediately killing it

What does the plasmodium parasite do to humans?

• It undergoes multiple changes in the human body: from sporozoite to trophozoite, to schizont, to merozoite and lastly gametocyte. These metamorphoses enable it to circumvent the barriers of its host’s immune system.

• Firstly it bursts and infects the liver cells and multiply until the liver cells explode releasing vast quantities of the parasite and the first symptom shivering.

• Then the parasite infects red blood cells causing them to burst and releasing the parasite into the bloodstream which means it can now be sucked up by a mosquito.

• This leads to shivering, fever and sweating in cycles with the bouts of fever occurring every two to three days.

• For cases such as plasmodium falciparum malaria can reach the brain and be fatal.

What happens to people who contract malaria repeatedly and what else is similar?

• People acquire partial immunity to the parasite

• Also people with sickle cell are more resistant to the disease

What percentage of malaria is endemic with malaria?

75%

What portion of Ethiopia live at risk to malaria?

Two thirds of the country live at risk to malaria

How is climate change increasing risk of malaria?

Because through global warming temperatures are rising leading to more conditions favourable to mosquitos and this is causing cases and risk to increase.

How have human factors increased risk of malaria in Ethiopa?

• Urbanisation has led to flooded excavations and garbage dumps creating breeding sites for mosquitos.

• Irrigation projects have led to the creation of more prolonged wet sites which has caused more consistent mosquito populations.

• At harvest large scale population movements occur between malaria-free highlands and agricultural lowlands which coincides with rainy season leading to spread of malaria throughout these populations as well.

• Also in harvest many workers sleep in fields at night leaving them vulnerable to mosquito bites.

How many episodes of malaria do Ethiopians suffer a year and how many die?

Around 5 million episodes a year which kills 70,000 people.

What are impacts of malaria?

• It slows economic growth and increases poverty as workers are killed and ill. Lost production in Sub-saharan africa estimated to be 12 million US dollars a year.

• Malaria is 40% of Ethiopia health expenditure a year, 10% of hospital admissions and 12% of health clinic visits.

• Malaria in Ethiopia also contributes to food insecurity by limiting development in the western areas and leading to highly dense populations which the resources cannot support.

• This food issue was one of the factors contributing to the devastating 1980s famine which Live Aid was for.

Side effects of some drugs to treat malaria?

Chloroquine impacts pH of cells to treat malaria and this can be toxic to humans too.

Where has resistance to drugs treating malaria emerged?

Resistance to chloroquine was first detected in Thailand 70 years ago and this led to the combination of drugs alongside melloquine.

What are the main methods for tackling malaria in Ethiopia?

• Insecticide-treated mosquito nets (ITNS)

• Indoor residual spraying (IRS)

• Mosquito larva source reduction

How protected are households in Ethiopia?

In 2015 it was estimated that 70% of households were protected from malaria due to insecticide treated mosquito nets and indoor residual spraying.