Ever since the cause of malaria was identified, the search for its treatment, and increasingly, the means to eliminate it from the world, has grown. Even though at one stage in the 80s and 90s of the previous century people were dying from certain variants of malaria, there has been a constant search for how to prevent people from getting malaria, and means of eradicating it. A document entitled From Aspiration to Action: What Will It Take to End Malaria? called for the total eradication of malaria by 2040. In this context, it is important to realize that over the last few years, the World Health Organization (WHO) has declared several countries as being free of malaria. China and Malaysia are the most notable among these.
There are many countries like the UK or USA where malaria does not occur naturally, but travelers might catch the infection when they visit certain countries in sub-Saharan Africa, especially the Democratic Republic of Congo and Nigeria; eastern Europe; Asian countries where malarial swamps have still not been drained; and some countries of central and south Americas like Papua New Guinea. Apart from the burden on the healthcare system, it is vital to consider the economic burden in terms of lost work days and income loss caused by malaria. Even though no vaccine has been developed to prevent malaria; there are several measures that can be taken by civic administrations and private individuals to prevent malaria from spreading. The need for concerted action to prevent or interrupt transmission cannot be overstated by using mosquito repellents or smoke guns to literally smoke out the vectors.
The main parasites which cause malaria are Plasmodium falciparum, P. vivax, P. ovale, and P. malariae. Of these, the malaria caused by Plasmodium falciparum has the highest death rate. Malaria is transmitted through the blood, usually, when a mosquito bites an infected person, and then bites a healthy individual. Other ways malarial parasites can travel are through an infected mother to her unborn child; sharing syringes which have not been sterilized properly ― a common enough practice among drug addicts; use of unscreened blood during a major surgical intervention. Lack of proper treatment, or incorrect treatment can make malaria a life threatening disease.
Artemisinin-based combination therapy (ACT) is usually recommended for simple, uncomplicated malaria by WHO. Unfortunately, some strains of malaria variants have become resistant to existing treatments, especially the older regimens used in the 50s and 60s of the 20th century. What is even more worrisome is that some mosquitoes are developing resistance to at least one insecticide.
The most vulnerable segments of society ― children under five years of age, expectant mothers, their unborn children, the poor, and the marginalized ― are the most susceptible to getting malaria. One of the reasons for this is the kind of unhygienic conditions they live in which aids in breeding mosquitoes. Even though there are over 3000 kinds of mosquitoes, only 30 types are carriers of diseases like malaria and dengue, of which only 5 types of mosquitoes cause malaria in humans. Therefore, the target has to be to eradicate those types of mosquitoes, and prevent them from breeding in public and private spaces.
Note that the achievement of the Sustainable Development Goals (SDGs), Goal 3: Good Health and Well-being; and Goal 6: Clean Water and Sanitation will contribute significantly towards making the world malaria free. They need to consider making malaria a notifiable disease. This will help the health departments of every region able to track the incidence, and transmission rates better. Further, they need to ensure that funding is not reduced when incidence rates begin to dip. They must actively pursue elimination.
Obviously, it is not a practical proposition to drain out every place where water collects, especially since it helps to recharge water tables in cities in some cases. In such places, using bleaching powder, and other chemicals to kill off larvae is one option to eliminate vector growth. However, civic administrations can carry out awareness campaigns to make people aware of the need to prevent water from accumulating in open tanks, unused flower pots, old tires, even empty coconut shells, and bolster parasite clearance. Keeping the slum areas clean, regular removal of garbage, encouraging the use of long-lasting insecticide-treated nets (LLINs), spraying DDT and DEET on open drains, and covering drains wherever possible are some of the actions which should be taken by civic administrations in cities, towns, suburbs, and villages.
Take these common sense steps to prevent malaria if you live in an area which is mosquito infested, and has a high incidence of malaria. Install window screens to prevent mosquitoes from entering the rooms. Ideally, have double doors for every room which can be entered from a verandah or the street, of which one should be of net or XPM. This will ensure that when you need to keep the door open, it does not become an open invitation to mosquitoes to enter the house.
Wearing long-sleeved clothes, and full length pants to prevent exposing skin is one such way, especially after sundown as malaria causing mosquitoes are busiest from dusk to dawn. If the heat makes wearing such clothes an impractical proposition; then use a mosquito repellent spray, lotion, or cream containing DEET on bare skin. Unfortunately, most of them wear off in an hour or two.
Spraying a repellent, or lighting a vaporizer containing permethrin to keep mosquitoes away when you are at work is another option. Lighting a mosquito coil might cause severe allergies in the long run, and aggravate asthma. Sleep under a mosquito net to keep them off you while you sleep. Try burning neem leaves to chase away the mosquitoes.