Malaria 101 - The basics: Starting at the beginning

Posted on November 14, 2023

Every year, on 25 of April and 6 November, we commemorate World Malaria Day and Southern African Development Community (SADC) Malaria Day, respectively. These annual events play a pivotal role in our collective efforts to combat malaria.  

The events create an opportunity to unite and make a difference, and they serve a crucial purpose: to raise awareness about malaria, encourage communities to become involved and participate in malaria control initiatives, and allow for resource mobilisation. At the same time challenges towards malaria elimination are highlighted, but most importantly our successes are celebrated. However, awareness creation should not only happen twice a year on these “special” days. Awareness creation should be a continuous occurrence, and both endemic and non-endemic communities need to be informed.

A  University of Pretoria Institute for Sustainable Malaria Control-branded extreme close-up image of a mosquito on a patch of skin

The University of Pretoria Institute for Sustainable Malaria Control creates a platform for diverse experts to bring their unique skills and knowledge to the table and join forces to address malaria holistically. 

In order to raise awareness about how to prevent the transmission of a deadly disease, one needs to know and understand the basics of that disease. Despite malaria being very complex, the disease can be simplified as follows:

What: Malaria is a serious and sometimes fatal vector-borne disease. A vector is something that carries a disease from one living organisms to another. In the case of malaria, the disease is caused by Plasmodium parasites. The vector or carrier of the disease is infected female Anopheles mosquitoes.

Why: Malaria transmission most commonly occurs when people get bitten by an infective mosquito. A mosquito becomes infected when it bites a person with malaria parasites in their blood. When the mosquito feeds again, about a week later, the parasites mix with the mosquito's saliva and are injected into the new person being bitten. The parasites enter the bloodstream and travel to the liver, then infect red blood cells. As the parasites multiply in the blood cells, symptoms, such as fever and chills, can be noted. It takes between 10 to 14 days from when the mosquito bit the person for symptoms to start. If left untreated, severe disease can develop, leading to organ damage and death.

Where: Malaria transmission boundaries are determined by the incidence and abundance of the mosquito vector, their susceptibility to the parasite, the type of hosts they feed on, and if they survive long enough to transmit the disease. Ambient humidity and temperature are important for both the vector and parasite. Therefore, malaria is typically found in warmer regions, such as tropical and subtropical regions, particularly in sub-Saharan Africa, Southeast Asia, and parts of South America, but is not limited to these areas.

Who: Astonishingly, nearly half of the world's population, around 3.2 billion people, are at risk of contracting malaria. This is a staggering number, underscoring the global reach of the disease. Sub-Saharan Africa shoulders a disproportionately high burden of malaria globally. In 2022 this region contributed 95% of malaria cases and 96% of malaria-related deaths. Anyone can be affected by malaria, especially when they live in an endemic area, but the disease affects certain groups more severely. Young children under the age of five, and pregnant women are particularly vulnerable and susceptible to the disease's grasp. Those living in or traveling to high-risk areas are at increased risk of contracting the disease. 

When: Malaria can occur year-round in areas where the Anopheles mosquitoes thrive, but the risk increases during the rainy season when there's more standing water for mosquito breeding. Malaria transmission occurs when the Anopheles mosquitoes feed. These mosquitoes feed at night, from dusk to dawn, with some Anopheles feeding most actively between 2am and 4am. They do not feed during the day.

The good news is that malaria is not an unbeatable foe. The disease is both preventable and treatable. Over the years, especially the past two decades, global, collective efforts have significantly reduced the impact of malaria in many regions. However, the disease is adapting and fighting back. We need to adapt our way of fighting the disease. We need to invest more, be more innovative, and implement strategies that will have actual impact.

Each and every person can make a difference, but our strength lies in unity. By coming together, sharing knowledge, and taking collective action, we can make a positive impact and work towards reducing the presence of malaria in our communities.

This is number one in a series of eight informative articles, where we will delve a bit deeper into malaria, look at the symptoms, touch on the A,B,C,Ds of malaria prevention, look at the importance of research, and see how each individual can contribute towards malaria elimination. In the next article we will explore the challenges of malaria in a bit more detail.

For more information, visit the webpage of the University of Pretoria Institute for Sustainable Malaria Control, a multi-disciplinary research institute making a substantial contribution towards the creation of a malaria-free Africa.

Read more from the Malaria 101 series
- Author Dr Taneshka Kruger

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