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The Impacts
of Malaria
From the WHO… 
Picture Source
Ancient History
Three of the parasites
evolved over 30 million years ago in Africa
--2.5 million years ago
for P. falciparum
323 BC: Alexander the
Great’s death was attributed to malaria
Modern History
1880: Charles Louis
Alphonse Laveran proposed that malaria was
caused by a protozoan; this was the first
time protozoa were identified as causing a
disease
1881: Carlos Finlay
suggested that mosquitoes transmitted
malaria
1898: Ronald Ross
showed that a mosquito species transmitted
malaria to birds
1900: Findings of
Carlos Finlay were confirmed by Walter Reed
1902: Ronald Ross
received a Nobel Prize for describing the
life cycle of the parasite
1907: Charles Louis
Alphonse Lavern won a Nobel Prize for his
discovery that malaria was caused by a
protozoan (among other findings)
1955: WHO inaugurated
its Global Malaria Eradication Campaign
Malaria as a cause
of death
One death every 30
seconds
-350 to 500 million
infected
-1.3 to 3 million
deaths annually
Picture:
Child being treated for malaria
Source
-85 to 90% of
fatalities = sub-Saharan Africa
-Children under 5
comprise the vast majority of cases
-Death rate expected to
double in the next 20 years
Why Children?
-Malaria induces human
immune response very slowly
-Children only develop
sufficient immunity after a few years of
constant exposure
-Immunity wanes if
removed from exposure (specific parasite)
Picture:
Most of
these children have already had malaria
Source
Distribution of
Malaria
Complex
-Malarial and malarial
free zones can be found in close proximity
More common in rural
areas
-Even in West Africa,
risk is lower in cities
-Incomplete data
because of location
Malaria’s Impacts on
GDP
-GDP between 1965 and
1990 rose only 0.4% annually in malarious
countries vs. 2.4% in non-malarious
countries
-GDP per capita
comparison in 1995 between malarious and
non-malarious countries found a five-fold
difference between the two
-Malaria costs Africa
$12 billion every year
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Socioeconomic Impacts
Costs of health
care
Working days lost due to
sickness
Days lost in education
Decreased productivity
(especially with cases of cerebral malaria)
Loss of investment and tourism
Socioeconomic Impact
Statistics
In some countries, the disease
is estimated to account for…
40% of public health
expenditure
30-50% of inpatient admissions
Up to 50% of outpatient visits
Vaccine
Research
No vaccine that will prevent
malaria but much research is being conducted
-RTS,S/AS02A is in phase II
trials
------Funded by the Gates
Foundation and GlaxoSmithKline
---Reduces infection risk by
30% and severity of infection by 50%
------Mozambican children in
2000
---Commercial release by 2010?
Picture:
Sample vaccine trial poster
Source
Other Advancements
2002: Genome of P.
falciparum completed; this could provide targets
for new drugs/vaccines
2002: University of Edinburgh
(2002) announced the discovery of an antibody that
protects against malaria
2002: Sterile insect techniques
utilized by scientists at Case Western brought about
a Plasmodium-resistant strain of Anopheles
Prevention and disease
control: Prevention is cheaper than treatment
US and Southern European
efforts were effective
--Drain wetland breeding
grounds/better sanitation
--Monitoring/treating those
infected
Some developing nations have
also been successful
--Conducive country conditions
--Targeted technical approach
--Active leadership at all
levels of government
--Decentralized implementation
(control of finances)
--Hands on technical/program
support
Prophylactic drugs
Not practical for those living
all the time in a malaria-endemic locale due to
their side effects and expense. However, they are
effective for short-term visitors. Their effects
are not immediate, and so some must be taken as
early as two week prior and four weeks after
exposure.
Picture Source
Indoor residual spraying
DDT developed around WWII; it
was quite controversial because of its effects when
used on a large-scale agricultural basis. The WHO
still advises the use of DDT in endemic areas,
however. It is quite effective, though still
stigmatized, when used to spray interior walls with
small quantities to control mosquitoes.
Mosquito Nets
Anopheles feeds
primarily at night, and thus, insecticide-treated
nets (ITN) around sleeping people are effective. In
fact, they are about 2 times as effective as
untreated nets. However, only 1 out of 20 Africans
own these nets. Nets can be readily obtained for 2
to 3 euros from the UN, WHO, others… One downside to
the nets is that they need to be re-impregnated
every 6 months; this creates numerous logistical
problems.
Picture:
Mosquito net
Source
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