Advances in the prevention of malaria
Malaria, a disease caused by Plasmodium parasites, and is one of the most serious diseases present on the globe today.
Malaria is prevalent in tropical and subtropical regions worldwide, with the highest burden concentrated in sub-Saharan Africa. Transmission occurs through the bite of a female Anopheles mosquito, which breeds in various freshwater sources such as puddles, rice fields, and hoof prints. The transmission of malaria often follows seasonal patterns corresponding to rainfall.
After an infected mosquito bite, the incubation period for malaria can range from one to four weeks, although longer periods are possible. Once the parasites multiply within red blood cells, Malaria can present with flu-like symptoms, such as fever, chills, and headaches. But if left untreated multi-organ disease may develop, potentially leading to fatal outcomes in severe cases.
Individuals with previous exposure to malaria may develop partial immunity, resulting in milder symptoms upon subsequent infections. At risk groups include children, pregnant women, and those with weak immune systems.
Preventing mosquito bites is key for anyone traveling to places where malaria is prevalent.
Malaria prevention
Fortunately, there are effective strategies to prevent malaria. Firstly, travellers are advised to check the malaria risk for the country they are travelling to at: https://travelhealthpro.org.uk/
If travelling to a malarial area, travellers should take the following precautions:
- Antimalarial medication: Travellers should consult a healthcare professional well in advance (ideally 4-6 weeks before travel) to discuss antimalarial medication. Different medications may be prescribed depending on the destination, due to varying local resistance patterns.
- Mosquito bite prevention: Employ mosquito bite prevention strategies, including insect repellents with DEET, wearing protective clothing, and using insecticide-treated mosquito nets, especially during peak mosquito activity times.
Long-term travellers have a higher risk of malaria than short-term travellers for several reasons, not just because their potential time of exposure is greater. They tend to underuse personal protective measures and adhere poorly to continuous anti-malarial prophylaxis.
Recent breakthroughs
For the first time, the global health community has witnessed the development and deployment of two promising malaria vaccines: RTS,S/AS01 (Mosquirix) and R21/Matrix-M.
These vaccines represent a breakthrough in malaria prevention, offering renewed hope in the fight against the disease.
RTS,S/AS01, the first malaria vaccine to receive regulatory approval, has shown moderate efficacy in clinical trials, providing partial protection against malaria in young children. While its effectiveness falls short of complete immunity, it offers a valuable tool in reducing the burden of severe malaria cases and associated mortality.
On the other hand, R21/Matrix-M, a more recent addition to the malaria vaccine arsenal, has demonstrated promising results in early-stage trials, boasting higher efficacy rates compared to its predecessor. Its formulation, coupled with the Matrix-M adjuvant, enhances the immune response, potentially conferring stronger and longer-lasting protection against malaria.
Vaccines against malaria are not yet available to the travel market. Their use is currently limited to the vaccination of children in endemic areas, maximising the impact of limited supplies.
It's remarkable to consider that a disease with such staggering global impact, potentially affecting 40% of the world's population and claiming nearly half a million lives annually, particularly among children under five, hasn't been met with a vaccine until recently.
For decades, organisations, governments, public health bodies, and pharmaceutical companies alike have pursued the development of a malaria vaccine. However, the microscopic nature of the malaria parasite presents unique challenges. It has evolved ingenious mechanisms to evade the body's immune system, acting as a "shapeshifter" by frequently changing its appearance to remain undetected.
Treatment of malaria
Early diagnosis and treatment are critical for preventing severe malaria and its complications. Rapid diagnostic tests can confirm malaria infection, with laboratory confirmation thereafter. Treatment typically involves a combination of antimalarial medications specific to the parasite strain with artemisinin-combination therapies the current standard due to their high efficacy.
The treatment duration depends on the severity of the infection and the specific medication used. In severe cases, hospitalisation, intravenous medications, and intensive care may be necessary.
If travellers are going somewhere located more than 24-hours from the nearest healthcare facility, doctors may prescribe malaria treatment to be taken if they become unwell and develop a fever. In such a scenario they should still seek medical help and malaria testing.
A promising future?
The introduction of a malaria vaccine holds the promise of further reducing childhood mortality from the disease, marking a significant step forward in our ongoing battle against malaria.
Malaria prevention and treatment require a multi-pronged approach. By combining travel precautions, effective medications, and ongoing research and development of new vaccines, we can continue the fight against this preventable disease.
Healix offer a malaria e-learning prevention course, which has been designed and written around the principles of malaria prevention and risk mitigation measures. To find out more, contact us at enquiries@healix.com.
