Malaria is a dangerous disease transmitted to humans by certain types of mosquitoes. Usually the disease is recorded in tropical countries. It is preventable and curable.
The infection is caused by a parasite and is not spread from person to person.
Symptoms can be both mild and extremely severe and life-threatening. Mild symptoms include fever, chills, and headache. Severe symptoms include extreme tiredness and weakness, confusion, seizures and shortness of breath
Infants, children under 5, pregnant women, travelers, and people with HIV or AIDS have the highest risk of severe disease.
There are several methods of preventing the disease: avoiding mosquito bites, preventive chemoprevention and vaccination. Timely treatment helps to prevent the development of a severe form of the disease.
Malaria is usually transmitted to humans through the bites of infected female Anopheles mosquitoes . Infection is also possible through blood transfusions and contaminated injection needles. The first symptoms of the disease can be mild, and it is difficult to diagnose malaria at this stage, because it can be confused with other diseases accompanied by fever. Without treatment, malaria caused by P. falciparum can progress to serious illness and lead to death within 24 hours.
There are 5 species of Plasmodium parasites that cause malaria in humans. 2 of them – P. falciparum and P. vivax – are the most dangerous. P. falciparum is the most dangerous malaria parasite, and it is the most common on the African continent. P. vivax is the dominant malaria parasite in most countries outside sub-Saharan Africa. Other species that can infect humans are P. malariae, P. ovale and P. knowlesi.
The most common early symptoms of malaria are fever, headache and chills.
Symptoms usually develop within 10-15 days after being bitten by an infected mosquito.
Symptoms may be mild, especially in people with a history of malaria. Because some malaria symptoms are non-specific, early testing is important.
Some types of malaria can lead to severe illness and even death. Babies, children under 5, pregnant women, travelers, and people with HIV or AIDS are at the highest risk of such a development. Serious symptoms include:
People with severe symptoms should get qualified medical attention immediately. Timely treatment of mild malaria can prevent worsening of symptoms, severe disease and death.
Malaria during pregnancy can lead to premature birth or low birth weight.
According to the World Malaria Report, 247 million cases of malaria were recorded in 2021, compared to 245 million cases in 2020. The total number of deaths due to malaria is estimated at 619,000 in 2021, compared to 625,000 in 2020.
The WHO African region continues to bear the greatest burden of disease compared to other regions. In 2021, this region accounted for about 95% of all malaria cases and 96% of all malaria deaths. About 80% of malaria deaths in the region occur in children under 5 years of age.
Four African countries account for more than half of the world's malaria deaths: Nigeria (31.3%), the Democratic Republic of the Congo (12.6%), the United Republic of Tanzania (4.1%) and Niger (3.9%).
Malaria can be prevented by preventing the bites of infected mosquitoes, taking certain medications and getting vaccinated (currently, the vaccine is available only for certain age groups in 12 African countries). Consult your doctor about taking antimalarial drugs before traveling to a malaria-endemic area .
You can reduce the risk of malaria infection by avoiding mosquito bites.
Vector control is the most important component of malaria control because it is extremely effective in preventing infection and reducing transmission of the virus. The two main vector control methods are insecticide-treated mosquito nets (ITNs) and indoor final-acting insecticide sprays (ILSPs).
Progress in the fight against malaria vectors may be slowed by the recently developing resistance of Anopheles mosquitoes to insecticides. Other threats to the effective use of vector control methods are insufficient access to OIS, their rapid wear during use, as well as a change in mosquito behavior: according to some data, there is a tendency to shift their activity to an earlier time, when people are not yet at home, so insects it is possible to avoid the action of insecticides.
Travelers to malaria-endemic areas should consult a doctor several weeks before travel. A medical professional will determine which medicine is suitable for you to prevent the disease depending on the country you are going to. In certain cases, chemoprophylaxis must be started 2-3 weeks before departure. Medicines must be taken according to the established schedule during the entire time of stay in the endemic area, as well as within 4 weeks from the moment of the last possible contact with infected mosquitoes, because it is during this time that the parasite is released from the liver.
Since 2019, African countries such as Ghana, Kenya and Malawi have received the world's first malaria vaccine thanks to the Malaria Vaccine Implementation Program (MVIP), coordinated by WHO and funded by the Gavi Vaccine Alliance, the Global Fund to Fight AIDS, Tuberculosis and Malaria, as well as Unitaid. The RTS,S/AS01 vaccine has been administered to more than 1.7 million children and has demonstrated safety and efficacy: the pilot vaccination program resulted in a significant reduction in severe malaria and deaths among children. At least 28 African countries have expressed interest in receiving this vaccine. So from October 2021 WHO recommends widespread use of RTS,S/AS01 malaria vaccine among children living in areas with moderate and high transmission of P. falciparum malaria. The vaccine has proven its ability to significantly reduce the incidence of malaria, particularly the fatal form of malaria, among young children.
In the period 2023–2025 thanks to the efforts of the Gavi Vaccine Alliance (Gavi), the World Health Organization (WHO) and the United Nations International Children's Fund (UNICEF), the 12 countries in Africa most in need of the vaccine to prevent malaria will receive 18 million doses. The Malaria Vaccine Implementation Program (MVIP) countries – Ghana, Kenya and Malawi – will receive the vaccine to continue the vaccination pilot project that has been underway there since 2019. Also, such 9 African countries as Benin, Burkina Faso, Burundi, Cameroon, Democratic Republic of Congo, Liberia, Niger, Sierra Leone and Uganda will receive the vaccine for the first time.
“This vaccine has the potential to significantly impact the malaria incidence situation; its use together with other preventive measures could prevent tens of thousands of deaths every year,” says Thabani Maphoza, regional managing manager of the Gavi Vaccine Alliance.
In October 2023, WHO approved the second malaria vaccine. The R21 vaccine is the second malaria vaccine recommended by WHO after the RTS, S/AS01 vaccine. Both vaccines have proven to be safe and effective in preventing malaria among children.
The WHO notes that the demand for malaria vaccines is unprecedented, but there is a shortage of available RTS,S. The addition of R21 to the list of WHO-recommended malaria vaccines is expected to ensure adequate supplies of the vaccine for all children living in areas where malaria is a public health risk.
"I used to dream of the day when we would have a safe and effective vaccine against malaria. Now we have two of them," said Tedros Adhanom Ghebreyesus, Director General of WHO.
The WHO says the effectiveness of the two vaccines is "very similar" and there is no evidence that one is better than the other.
"This second vaccine has real potential to close the huge gap between demand and supply," said WHO's regional director for Africa, Matshidiso Moeti.
The R21 vaccine is 75% effective in preventing disease in regions where malaria is seasonal. WHO states that this high efficacy is similar to that demonstrated with seasonal administration of RTS,S.
The public health impact of the R21 vaccine is expected to be high.
At a cost of US$2-4 per dose, the cost-effectiveness of the R21 vaccine would be comparable to other recommended antimalarial interventions, requiring four doses per person.
To date, there is no evidence that one vaccine – R21 or RTS,S – works better than the other. The selection of a vaccine for use in a country should be based on its availability and affordability.
Clinical trials have shown that the R21 vaccine is safe. As with other new vaccines, safety monitoring will continue.
Timely diagnosis and treatment of malaria help reduce the severity of the course of the disease and prevent the death of the patient, as well as contribute to reducing the intensity of malaria transmission. WHO recommends that in all cases of suspected malaria, confirm the diagnosis with a diagnostic test for the detection of the parasite (microscopic examination or diagnostic express test).
Malaria is a serious infection and requires medical treatment in all cases.
A number of medicines are used to prevent and treat malaria. The doctor prescribes one or more drugs based on:
The most common antimalarial drugs are listed below.
Most drugs are available in the form of tablets. Some people may need injections in a medical center or hospital.
Over the past decade, global malaria control efforts have begun to be hampered by the development of partial resistance of the parasite to artemisinin-based drugs in the Greater Mekong subregion. WHO is concerned about reports of partial resistance to artemisinin in Africa, which has been confirmed in Eritrea, Rwanda and Uganda. In order to develop treatment strategies for malaria-endemic countries, as well as timely detection and control of drug resistance, it is necessary to conduct regular monitoring of the effectiveness of antimalarial drugs.