Malaria has been reported in Malaysia even before 1900’s.

In 1990, there were 50,500

cases in Malaysia. A decade later, in the year 2000, the number of reported cases has reduced
to 12,705 cases. In 2012, there were 4,725 cases which is a 63% reduction compared to 2000.
The incidence rate in Malaysia has declined to less than 1 per 1,000 population since 1998. There
has also been a reduction in the number of malaria deaths from 43 in 1990 to 35 in 2000 and to
16 deaths in 2012. The mortality rate due to malaria has been around 0.001 per 1,000 population
since 2006. All figures and rates are inclusive of P. knowlesi. The first case of Plasmodium
knowlesi has been reported in Malaysia in 1965. Based on 2012, P. knowlesi accounted for 38%
(1813) of all cases which is the highest among all Plasmodium species. Plasmodium knowlesi
followed by Plasmodium falciparum causes the most serious form of disease in Malaysia.

Malaria is caused by Plasmodium parasites which are falciparum, vivax, malariae, and
ovale. The most dangerous of the four is Plasmodium falciparum. The parasites are spread to
people through the bites of infected Anopheles mosquitoes, called "malaria vectors", which bite
mainly between dusk and dawn. The period of communicability of malaria are when the
mosquitoes become infective after 10-18 days after picking gametocytes from infected human.
These gametocytes develop into sporozoites in the mosquito and start to enter its salivary glands.
When mosquito bites susceptible person, then it will transmit the sporozoites into the susceptible
host. If it is left untreated the parasite will remain in the host which are Plasmodium vivax up to 2-
5 years, Plasmodium falciparum less than 1 year, Plasmodium ovale up to 2-5 years and
Plasmodium malariae for several years.

We must know the early symptoms of malaria are non-specific and similar to the symptoms
of a minor systemic viral illness such as headache, lassitude, fatigue, abdominal discomfort,
muscle and joint aches, usually followed by fever, chills, perspiration, anorexia, vomiting and
worsening malaise. The most common appearance of malaria is high fever. The classical
paroxysm begins abruptly with an initial cold stage, with dramatic rigors during which the patient
shakes visibly. This leads to a hot stage in which the patient has a temperature of more than
40°C, may be restless and excitable and may vomit or shivering, and finally a sweating stage,
when the fever drops and the patient may fall asleep.

There are many transmission modes of malaria such as by the bites of female anopheles
mosquito, blood transfusion, mother to the growing fetus and needle stick injury among drug
addicts. The reservoir for malaria are human and monkey. The following control measures are
often combined in order to control malaria cases which are case management, prevention of
infection through vector control and prevention of disease by ACD (Active Case Detection) and
PCD (Passive Case Detection). Other than that, these activities can be carried out for malaria
control by health education, training and supervision of health workers and provision of equipment
and supplies. We can diagnose malaria by rapid diagnostic test kit and blood film for malaria
parasite microscopy. In P. falciparum malaria, additional laboratory findings may include mild
anemia, mild decrease in blood platelets (thrombocytopenia), elevation of bilirubin, elevation of
aminotransferases, albuminuria, and the presence of abnormal bodies in the urine.

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 Furthermore, malaria can be control and prevent by vector control activities such as
elimination of Anopheles vector breeding in urban areas, larviciding, fogging, indoor residual
spraying (IRS) which is a powerful way to rapidly reduce malaria transmission and its full potential
is realized when at least 80% of houses in targeted areas are sprayed. Indoor spraying is effective
for 3–6 months, depending on the insecticide used and the type of surface on which it is sprayed.
Next is insecticide treated nets (ITN) that is a Long-lasting insecticidal nets (LLINs) for public
health distribution programmes. This is recommends for all at-risk persons, to high risk local
population and in outbreak areas. The most cost effective way to achieve this is through provision
of free LLINs, so that everyone sleeps under a LLIN every night. Vector control measures
implemented in malaria stratified areas. Antimalarial drugs are designed to attack the parasites
that cause malaria, preventing them from spreading while also killing them off, so they cannot
continue causing infection. For travellers, malaria can be prevented through chemoprophylaxis,
which suppresses the blood stage of malaria infections, thereby preventing malaria disease and
immediately seek diagnosis and treatment if a fever develops one week or more after entering an
area where there is a malaria risk and up to three months after departure from a risk area.
Besides, we must avoid being bitten by mosquitoes, especially between dusk and dawn, use
protective clothing like long sleeves and pants and use insect repellents.

As a conclusion, we must take note to this diseases because it can cause outbreak in
Malaysia. We need to monitor the incidence and distribution of malaria so that we can alert public
to avoid the disease. Preventive measures are very important in order to eliminate malaria fever.
Besides that, access to early diagnosis and treatment along with the cooperation of communities
are main to achieve all Malaysia’s malaria program. Thus, the community should aware about the
increasing cases of malaria in our country. Last but not least, we need to practice all the
prevention ways to avoid this diseases to make sure our environment will be clean and save for
the next generation.

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APPENDIX

FIGURE 1 : Malaria cases reported by states in Malaysia, 2013

FIGURE 2 : Malaria Deaths and Case Fatality Rate in Malaysia, 2000-2012

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 FIGURE 3 : Malaria lifecycle

FIGURE 4 : Indoor Residual Spraying (IRS)

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REFERENCES

Malaria. (n.d.). Retrieved 30 December 2014from

http://www.cdc.gov/malaria/about/disease.html

Malaria. (2014, December). Retrieved from http://www.who.int/mediacentre/factsheets/fs094/en/

Malaria in Malaysia. (n.d.). Retrieved 30 December 2014 from

http://www.mpc.gov.my/mpc/images/file/eos3.pdf

Wiwanitkit, V. (2007). Malaria Research in Southeast Asia. New York: Nova Science Publishers,
Inc.