Malaria
The disease that continues to kill 2.7 million people
every year.
In December 2008, researchers at the annual meeting of the
American Society of Tropical Medicine and Hygiene warned that
malaria is no longer just a developing-country problem. Global
warning and international travel are increasing the risk that the
disease could spread to previously malaria-free zones of the United
States of America and Europe. An infected mosquito can get onto a
plane in an affected region, get off again in a new country and
bite someone in or near the airport. Or an infected traveller may
travel home and be bitten by a local mosquito, which then becomes
infected and bites someone else in the area. In a warming world,
where mosquitoes live longer and lay more eggs, the infection can
then take hold in mosquito and human populations of the destination
country.
The news is cause for concern in the West because there is as
yet no vaccine against malaria - and the parasite develops
resistance to anti-malarial drugs very quickly. A study published
in July 2009 shows that malaria parasites in western Cambodia have
now become resistant to artemisinin-based therapies, the current
first-line treatment and most effective drug in the world's arsenal
against the disease.
This is disturbing news, because although malaria is a curable
disease, it has to be treated promptly and adequately - the
parasite must be completely eliminated from the body so that it
cannot linger to develop resistance to the drug being used.
Untreated or inadequately treated malaria kills 2.7 million people
each year. Most are children, but other vulnerable groups include
pregnant women, travellers who have not had a chance to build up
immunity to the disease, refugees, or labour forces entering
endemic areas.
There is also a wider social and economic impact on entire
communities. The local labour force may be decimated by death and
fever, children orphaned and left dependent on communal resources,
or parents left childless and without the support they need to
hunt, farm and or carry out other survival activities.
The culprit in the transmission of the disease is the female
Anopheles mosquito. Through its role in transmitting malaria and
yellow fever, it is claimed that this tiny creature has killed more
than half the humans that have ever lived. It has also been around
a lot longer than modern humans; fossils of mosquitoes up to 30
million years old show that the malaria vector was around then,
whilst we can only trace our earliest ancestors back to around six
million years ago.
The disease itself is caused by the Plasmodium parasite - a tiny
single-celled parasite carried by the Anopheles mosquito that
infects the cells in our bodies. Four species of the Plasmodium
parasite cause human malaria of differing degrees of severity: P.
falciparum, P. vivax, P. ovale and P. malariae.
The recently completed Malaria Atlas Project - the most detailed
map ever created of malaria risk worldwide - shows that 2.4 billion
people are at risk from P. falciparum, the most deadly form of
malaria, but highlights some promising news: three-quarters live in
areas where risk is considered very low and the technical obstacles
to malaria control are relatively small.
Scientific developments are also bringing hope to the fight
against the disease. In 2002, the genomes of the P. falciparum
parasite and Anopheles gambiae mosquito were published. These are
now helping researchers to tease apart the interactions between the
parasite and humans, and the parasite and mosquitoes, as it moves
through the different stages of its lifecycle.