CONTENTS

 INTRODUCTION
 KEY FACTS
 CAUSES
 TRANSMISSION
 PREVENTION
 TREATMENT
 WHO responses..
 CASE STUDY
 BIBLIOGRAPHY
 INTRODUCTION
Malaria is a mosquito-borne infectious disease affecting humans and other animals caused
by parasitic single-celled microorganisms belonging to the Plasmodium group. Malaria
causes symptoms that typically include fever, tiredness, vomiting, and headaches. In severe cases it can
cause yellow skin, seizures, coma, or death. Symptoms usually begin ten to fifteen days after being
bitten by an infected mosquito. If not properly treated, people may have recurrences of the disease
months later. In those who have recently survived an infection, reinfection usually causes milder
symptoms. This partial resistance disappears over months to years if the person has no continuing
exposure to malaria.
The disease is most commonly transmitted by an infected female Anopheles mosquito. The mosquito
bite introduces the parasites from the mosquito's saliva into a person's blood. The parasites travel to
the liver where they mature and reproduce. Five species of Plasmodium can infect and be spread by
humans. Most deaths are caused by P. falciparum because P. vivax, P. ovale, and P. malariae generally
cause a milder form of malaria. The species P. knowlesi rarely causes disease in humans. Malaria is
typically diagnosed by the microscopic examination of blood using blood films, or with antigen-
based rapid diagnostic tests. Methods that use the polymerase chain reaction to detect the
parasite's DNA have been developed, but are not widely used in areas where malaria is common due to
their cost and complexity.
The risk of disease can be reduced by preventing mosquito bites through the use of mosquito
nets and insect repellents, or with mosquito control measures such as spraying insecticides and
draining standing water. Several medications are available to prevent malaria in travelers to areas where
the disease is common. Occasional doses of the combination medication sulfadoxine/pyrimethamine are
recommended in infants and after the first trimester of pregnancy in areas with high rates of
malaria. Despite a need, no effective vaccine exists, although efforts to develop one are ongoing. The
recommended treatment for malaria is a combination of antimalarial medications that includes
an artemisinin. The second medication may be either mefloquine, lumefantrine, or
sulfadoxine/pyrimethamine. Quinine along with doxycycline may be used if an artemisinin is not
available. It is recommended that in areas where the disease is common, malaria is confirmed if possible
before treatment is started due to concerns of increasing drug resistance. Resistance among the
parasites has developed to several antimalarial medications; for example, chloroquine-
resistant P. falciparum has spread to most malarial areas, and resistance to artemisinin has become a
problem in some parts of Southeast Asia.
The disease is widespread in the tropical and subtropical regions that exist in a broad band around
the equator. This includes much of Sub-Saharan Africa, Asia, and Latin America. In 2016, there were 216
million cases of malaria worldwide resulting in an estimated 445,000 to 731,000 deaths. Approximately
90% of both cases and deaths occurred in Africa. Rates of disease have decreased from 2000 to 2015 by
37%, but increased from 2014 during which there were 198 million cases. Malaria is commonly
associated with poverty and has a major negative effect on economic development. In Africa, it is
estimated to result in losses of US$12 billion a year due to increased healthcare costs, lost ability to
work, and negative effects on tourism.
 KEY FACTS
 Malaria is transmitted when a mosquito infected with the plasmodium parasite bites a
person. The mosquito acts as a carrier of the plasmodium meaning when a mosquito
bites a person infected with malaria, there is a high chance that the parasite can be
spread to a healthy individual when this mosquito bites that person.
 Did you know that malaria can be caused by four variants of the same parasite?
 Malaria is especially dangerous for pregnant women as the parasite can pass into the
mother’s womb and infect the foetus as well. Once the foetus has been infected with
malaria, it can lead to the baby being born with a low birth weight and may lead to
death.
 CAUSES
Malaria is caused by the Plasmodium parasite. The parasite can be spread to humans through
the bites of infected mosquitoes.

There are many different types of plasmodium parasite, but only 5 types cause malaria in
humans.

These are:
 Plasmodium falciparum – mainly found in Africa, it's the most common type of malaria parasite
and is responsible for most malaria deaths worldwide
 Plasmodium vivax – mainly found in Asia and South America, this parasite causes milder
symptoms than Plasmodium falciparum, but it can stay in the liver for up to 3 years, which can
result in relapses
 Plasmodium ovale – fairly uncommon and usually found in West Africa, it can remain in your
liver for several years without producing symptoms
 Plasmodium malariae – this is quite rare and usually only found in Africa.
 Plasmodium knowlesi – this is very rare and found in parts of southeast Asia.
 TRANSMISSON
The plasmodium parasite is spread by female Anopheles mosquitoes, which are known as
"night-biting" mosquitoes because they most commonly bite between dusk and dawn.

If a mosquito bites a person already infected with malaria, it can also become infected and
spread the parasite on to other people. However, malaria can't be spread directly from person
to person.

Once you're bitten, the parasite enters the bloodstream and travels to the liver. The infection
develops in the liver before re-entering the bloodstream and invading the red blood cells.

The parasites grow and multiply in the red blood cells. At regular intervals, the infected blood
cells burst, releasing more parasites into the blood. Infected blood cells usually burst every 48-
72 hours. Each time they burst, you'll have a bout of fever, chills and sweating.

Malaria can also be spread through blood transfusions and the sharing of needles, but this is
very rare.
 PREVENTION
There's a significant risk of getting malaria if you travel to an affected area. It's very important
you take precautions to prevent the disease.

Malaria can often be avoided using the ABCD approach to prevention, which stands for:
 Awareness of risk – find out whether you're at risk of getting malaria.
 Bite prevention – avoid mosquito bites by using insect repellent, covering your arms and legs,
and using a mosquito net.
 Check whether you need to take malaria prevention tablets – if you do, make sure you take
the right antimalarial tablets at the right dose, and finish the course.
 Diagnosis – seek immediate medical advice if you have malaria symptoms, including up to a
year after you return from travelling.

These are outlined in more detail below.

Being aware of the risks

To check whether you need to take preventative malaria treatment for the countries you're
visiting, see the Fit for Travel website.

It's also important to visit your GP or local travel clinic for malaria advice as soon as you know
where you're going to be travelling.

Even if you grew up in a country where malaria is common, you still need to take precautions to
protect yourself from infection if you're travelling to a risk area.

Nobody has complete immunity to malaria, and any level of natural protection you may have
had is quickly lost when you move out of a risk area.

Preventing bites

It's not possible to avoid mosquito bites completely, but the less you're bitten, the less likely
you are to get malaria.

To avoid being bitten:

 Stay somewhere that has effective air conditioning and screening on doors and windows. If this
isn't possible, make sure doors and windows close properly.
 If you're not sleeping in an air-conditioned room, sleep under an intact mosquito net that's
been treated with insecticide.
 Use insect repellent on your skin and in sleeping environments. Remember to reapply it
frequently. The most effective repellents contain diethyltoluamide (DEET) and are available in
sprays, roll-ons, sticks and creams.
 Wear light, loose-fitting trousers rather than shorts, and wear shirts with long sleeves. This is
particularly important during early evening and at night, when mosquitoes prefer to feed.

There's no evidence to suggest homeopathic remedies, electronic buzzers, vitamins B1 or B12,

garlic, yeast extract spread (such as Marmite), tea tree oils or bath oils offer any protection
against mosquito bites.

Antimalarial tablets

There's currently no vaccine available that offers protection against malaria, so it's very
important to take antimalarial medication to reduce your chances of getting the disease.

However, antimalarials only reduce your risk of infection by about 90%, so taking steps to avoid
bites is also important.

When taking antimalarial medication:

 make sure you get the right antimalarial tablets before you go – check with your GP or
pharmacist if you're unsure
 follow the instructions included with your tablets carefully
 depending on the type you're taking, continue to take your tablets for up to 4 weeks after
returning from your trip to cover the incubation period of the disease

Check with your GP to make sure you're prescribed a medication you can tolerate. You may be
more at risk from side effects if you:
 have HIV or AIDS
 have epilepsy or any type of seizure condition
 are depressed or have another mental health condition
 have heart, liver or kidney problems
 take medicine, such as warfarin, to prevent blood clots
 use combined hormonal contraception, such as the contraceptive pillor contraceptive patches

If you've taken antimalarial medication in the past, don't assume it's suitable for future trips.
The antimalarial you need to take depends on which strain of malaria is carried by the
mosquitoes and whether they're resistant to certain types of antimalarial medication.

In the UK, chloroquine and proguanil can be bought over-the-counter from local pharmacies.
However, you should seek medical advice before buying it as it's rarely recommended
nowadays. For all other antimalarial tablets, you'll need a prescription from your GP.

Read more about antimalarial medication, including the main types and when to take them.
 Get immediate medical advice

You must seek medical help straight away if you become ill while travelling in an area where
malaria is found, or after returning from travelling, even if you've been taking antimalarial
tablets.

Malaria can get worse very quickly, so it's important that it's diagnosed and treated as soon as
possible.

If you develop symptoms of malaria while still taking antimalarial tablets, either while you're
travelling or in the days and weeks after you return, remember to tell the doctor which type
you have been taking. The same type of antimalarial shouldn't be used to treat you as well.

If you develop symptoms after returning home, visit your GP or a hospital doctor and tell them
which countries you've travelled to in the last 12 months, including any brief stopovers.

DEET insect repellents

The chemical DEET is often used in insect repellents. It's not recommended for babies who are
less than 2 months old.

DEET is safe for older children, adults and pregnant women if you follow the manufacturer's
instructions:
 use on exposed skin
 don't spray directly on to your face – spray into your hands and pat on to your face
 avoid contact with lips and eyes
 wash your hands after applying
 don't apply to broken or irritated skin
 make sure you apply DEET after applying sunscreen, not before.
 TREATMENT
Malaria is treated with antimalarial medications; the ones used depends on the type and
severity of the disease. While medications against fever are commonly used, their effects on
outcomes are not clear.
Simple or uncomplicated malaria may be treated with oral medications. The most effective
treatment for P. falciparum infection is the use of artemisinins in combination with other
antimalarials (known as artemisinin-combination therapy, or ACT), which decreases resistance
to any single drug component. These additional antimalarials
include: amodiaquine, lumefantrine, mefloquine or sulfadoxine/pyrimethamine.[94] Another
recommended combination is dihydroartemisinin and piperaquine. ACT is about 90% effective
when used to treat uncomplicated malaria. To treat malaria during pregnancy, the WHO
recommends the use of quinine plus clindamycin early in the pregnancy (1st trimester), and
ACT in later stages (2nd and 3rd trimesters). In the 2000s (decade), malaria with partial
resistance to artemisins emerged in Southeast Asia. Infection
with P. vivax, P. ovale or P. malariae usually do not require hospitalization. Treatment
of P. vivax requires both treatment of blood stages (with chloroquine or ACT) and clearance of
liver forms with primaquine. Treatment with tafenoquine prevents relapses after confirmed P.
vivax malaria.
Severe and complicated malaria are almost always caused by infection with P. falciparum. The
other species usually cause only febrile disease. Severe and complicated malaria are medical
emergencies since mortality rates are high (10% to 50%). Cerebral malaria is the form of severe
and complicated malaria with the worst neurological symptoms. Recommended treatment for
severe malaria is the intravenous use of antimalarial drugs. For severe
malaria, parenteral artesunate was superior to quinine in both children and adults. In another
systematic review, artemisinin derivatives (artemether and arteether) were as efficacious as
quinine in the treatment of cerebral malaria in children. Treatment of severe malaria involves
supportive measures that are best done in a critical care unit. This includes the management
of high fevers and the seizures that may result from it. It also includes monitoring for poor
breathing effort, low blood sugar, and low blood potassium.
 WHO response…
The WHO Global Technical Strategy for Malaria 2016-2030 – adopted by the World Health
Assembly in May 2015 – provides a technical framework for all malaria-endemic countries. It is
intended to guide and support regional and country programmes as they work towards malaria
control and elimination.

The Strategy sets ambitious but achievable global targets, including:

 Reducing malaria case incidence by at least 90% by 2030.

 Reducing malaria mortality rates by at least 90% by 2030.
 Eliminating malaria in at least 35 countries by 2030.
 Preventing a resurgence of malaria in all countries that are malaria-free.

This Strategy was the result of an extensive consultative process that spanned 2 years and
involved the participation of more than 400 technical experts from 70 Member States. It is
based on 3 key pillars:

 ensuring universal access to malaria prevention, diagnosis and treatment;

 accelerating efforts towards elimination and attainment of malaria-free status; and
 Transforming malaria surveillance into a core intervention.

The WHO Global Malaria Programme (GMP) coordinates WHO's global efforts to control and
eliminate malaria by:

 setting, communicating and promoting the adoption of evidence-based norms,

standards, policies, technical strategies, and guidelines;
 keeping independent score of global progress;
 developing approaches for capacity building, systems strengthening, and surveillance;
and
 Identifying threats to malaria control and elimination as well as new areas for action.

GMP is supported and advised by the Malaria Policy Advisory Committee (MPAC), a group of 15
global malaria experts appointed following an open nomination process. The MPAC, which
meets twice yearly, provides independent advice to WHO to develop policy recommendations
for the control and elimination of malaria. The mandate of MPAC is to provide strategic advice
and technical input, and extends to all aspects of malaria control and elimination, as part of a
transparent, responsive and credible policy setting process.
 BIBLIOGRAPHY
I am able to make this project and collect the information from the following resources:

 NCERT BIOLOGY TEXTBOOK CLASS XII

 OUR BIOLOGY TEACHER: MRS. ANUPAMA MISHRA
 http://www.who.int/news-room/fact-sheets/detail/malaria
 KIMS BHUBANESWAR