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Malaria is a life-threatening condition caused due to a parasitic infection. The parasite is a protozoon, which belongs to the genus Plasmodium. There are various species of Plasmodium which may cause different types of malaria. In the basic form of the disease, the parasite multiplies in the host red blood corpuscles to complete their life cycle. This leads to the destruction of RBC’s and the individuals infected with the malaria parasite suffers from anemia and physiological distress, which may become life-threatening if it is untreated. The plasmodium parasite enters the human or animal body, through the bite of female Anopheles mosquito (Fairhurst & Wellems 3437-3462).
Malaria is a global epidemic and is prevalent more in developing or underdeveloped nations. There has been a global consensus on abatement of malaria through proper hygienic principles related to waste management. However, malaria remains to be one of the major concerns, across various nations. Management and treatment of individuals affected by malaria are aggressive. However, fatalities do occur due to inappropriate awareness regarding the disease. This article is an endeavor to highlight the etiology of malaria and its impact on human beings (Fairhurst & Wellems 3437-3462).
Epidemiology & Historical Perspective
The word “Malaria” comes from the two words “Mal” meaning bad and “Aria” meaning air. Hence, malaria was thought to be caused by bad air or polluted air. The word “malaria” was coined by the Greek physician Hippocrates. During those days, the disease created a menace in individuals who lived in unhealthy places. Hence, the concept of bad air or foul air or “malaria” was created. However, it was in 1880 when the French Scientist Alphonso Laveran discovered Plasmodium, the actual cause of malaria. In the year 1900 a group of scientists belonging to India and Italy discovered that such parasites spread in human beings through the bites of female Anopheles mosquito (Fairhurst & Wellems 3437-3462).
Malaria is more prevalent in Central and South Americas, Asia, and Africa. In a single year around 350 to 500 million individuals, are affected by malaria, all across the world. Amongst them, one million people die and most of them are children. Some countries like United States of America have nearly eradicated the menace of malaria. However, more than hundreds (approximately 1200 individuals) still suffer from malaria in the United States per year (Fairhurst & Wellems 3437-3462).
Types of Malaria
Malaria is caused by the unicellular protozoon of the genus Plasmodium. There are various species of Plasmodium, and each is associated with different types of malaria. Plasmodium vivax is the most common cause of malaria and the type of malaria is called “Vivax malaria.” This type of malaria is prevalent in tropical countries and is associated with a high degree of relapse. Plasmodium falciparum is the major pathogen associated with deaths occurring from malaria. This type of malaria infection has a sudden onset of action and often becomes life threatening. However, appropriate diagnosis and effective treatment may reduce the chances of mortality (Fairhurst & Wellems 3437-3462). Another pathogen called Plasmodium malaria is also responsible for another form of malaria that produces the typical symptoms of “Vivax malaria”, but has a long lasting effect. It thrives in the blood for decades and may persist symptomless within the human body. Plasmodium ovale is another type of malaria pathogen, which is prevalent in Western African countries (Nadjm & Behrens 243-259).
The malaria parasites completes one-half of its life cycle in the female anopheles mosquito while the other half of the life cycle occurs in human blood. In female mosquitoes, sexual reproduction of Plasmodium takes place while, in the human blood, Plasmodium reproduces asexually. The first part of asexual reproduction occurs in the liver cells, which is then transferred to the RBCs. When a female Anopheles mosquito bites a human, sporozoites (the infective form of the pathogen) enters the human blood from the saliva of the Anopheles mosquito(Nadjm & Behrens 243-259).
After entry into the human blood, sporozoite reaches the liver cells and develops into a schizont within two weeks of time. The conversion of sporozoite into a schizont occurs in the liver and this phase is called the “schizont cycle.” The schizont contains thousands of merozoites. As the schizonts mature, these merozoites are released into the blood, where it enters the red blood corpuscles (Fairhurst & Wellems 3437-3462).
These merozoites mature in the RBCs through another phase of asexual reproduction and again form schizonts. These schizonts come out of the RBCs, by rupturing the RBCs. This leads to a loss of hemoglobin and causes anemia in the affected individual. Not all the merozoites are transformed into schizonts. Some merozoites do not reproduce asexually and remain dormant in the blood stream of humans as gametocytes. When a female anopheles mosquito bites such affected individuals, the gametocytes are taken up into the stomach of female anopheles mosquito. In the stomach, the gametocyte fuses with the female oocyte and develops into the oocyst. Oocyst is filled with the infective sporozoites. Thus when the mosquito once again bites another human, these sporozoites enter the human blood stream and the life cycle continues (Nadjm & Behrens 243-259).
Symptoms of Malaria
The symptoms of malaria include fever, chills, sweat, and anemia. A headache is often associated with malaria. Malaise, fatigue, muscular cramps and pain, and nausea are also some of the common symptoms. In severe cases diarrhea and vomiting take, this requires the individual to be hospitalized. The symptoms of malaria occur after 10 to 16 days from the bite of an infectious female Anopheles mosquito (Fairhurst & Wellems 3437-3462).
Spread of Malaria
Malaria often becomes an epidemic, when there is the failure to prevent the population of female Anopheles mosquitoes. The larva of these mosquitoes thrives in still and stagnant water bodies and in unhygienic places. Therefore, inadequate sewage and improper disposal of municipal wastes encourages the growth of female Anopheles mosquitoes (Fairhurst & Wellems 3437-3462).
Prevention and Management
Fumigation of water bodies and effective disposal of municipal wastes may reduce the prevalence of malaria. Interestingly it is noted that people who suffer from a unique disease called sickle cell anemia are resistant to malaria. This is because they have defective hemoglobin in their RBCs, which causes the premature destruction of RBCs. Since, RBCs are destroyed; therefore these pathogens cannot thrive longer. Some individuals belonging to African population has this sickle cell trait and is, therefore, resistant to malaria. It is also noted that individuals who carry hemoglobin C in their RBCs are resistant to malaria too. Hemoglobin C causes the destruction of a parasite protein called PfEMP 1. This protein is deployed by the merozoites to enter into the RBCs. Since, the protein itself gets destroyed; therefore it can neither attach with RBC membrane nor can enter RBCs. Thus the chance of malaria decreases, in such individuals. Vivax malaria is managed by quinine group of medications while falciparum is treated with artesunate (Nadjm & Behrens 243-259).
Fairhurst RM, & Wellems TE. “Chapter 275. Plasmodium species (malaria)”. In Mandell GL,
Bennett JE, Dolin R (eds). Mandell, Douglas, and Bennett’s Principles and Practice of
Infectious Diseases 2 (7th ed.). Philadelphia, Pennsylvania: Churchill
Livingstone/Elsevier. 2010, pp 3437–62.
Nadjm B, & Behrens RH. “Malaria: An update for physicians”. Infectious Disease Clinics of
North America 26 .2(2012): pp.243–59
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