Malaria: Prevention and Treatment

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  • 0:06 Malaria in the United States
  • 2:21 Malaria Prevention Methods
  • 6:20 Malaria Treatment
  • 7:48 Lesson Summary
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Lesson Transcript
Instructor: Angela Hartsock

Angela has taught college Microbiology and has a doctoral degree in Microbiology.

In this lesson examining malaria, we will look at the impact of the disease in the U.S. and the major methods of preventing the disease. We will also discuss how to correctly treat patients stricken by malaria.

Malaria in the United States

In a previous lesson, we looked at the protozoa parasite that causes malaria, Plasmodium. This parasite is spread through the bite of an infected female Anopheles mosquito to a human host. Plasmodium causes malaria by invading the red blood cells of the host, multiplying, and bursting the infected cells all at once. This synchronous bursting of red blood cells causes all the symptoms of the disease.

Over 90% of malaria cases occur in Africa, causing over 600,000 deaths annually. To people living in the United States, malaria probably seems like an exotic and foreign disease and no more of a daily threat to us than getting mauled by a pride of lions. It might surprise you to learn that in 1935, the United States had almost 4,000 deaths from malaria. By the 1950s, that number had dropped to around 25. Today, the United States averages less than one malaria death per year.

So what happened? Well, in the 1930s, the government started a massive, multi-year eradication and prevention program. Thousands of miles of ditches were dug, draining 500,000 acres of swamps in southern states that were confirmed Anopheles mosquito breeding habitats. Millions of gallons of oil were dumped on the surfaces of other swamps, suffocating the aquatic larval mosquitoes. By the 1940s, the insecticide DDT was sprayed in infected areas to kill mosquitoes. People living in malaria hotspots were given drugs to prevent them from getting infected, thus eliminating the human step in the Plasmodium lifecycle.

The point of this story is that multifaceted and organized prevention measures can be a powerful tool for eliminating malaria. Yet despite this, worldwide deaths are still occurring at staggering rates. Let's continue our investigation of malaria by looking at the main prevention methods in use today.

Prevention Methods

Prevention of malaria can take three paths. We can target:

  1. The mosquito that transmits the disease
  2. The human host that acts as a reservoir
  3. The Plasmodium that is responsible for the disease itself

Let's look at each strategy.

In 1930s America, prevention targeted the mosquitoes, who lay their eggs in stagnant water. Draining swamps and spraying insecticides in breeding habitats reduces the mosquito populations and can be very effective. The discovery of the insecticide DDT was supposed to be the death knell for malaria. The chemical kills adults and larval mosquitoes, is cheap, and is easy to use. However, nature is rarely defeated so easily. DDT-resistant mosquitoes quickly evolved. The chemical was also linked to thinning bird eggshells and other environmental impacts. It's because the world has become more environmentally conscious that these methods are losing popularity. The insecticide DDT was eventually banned in the United States in the 1970s.

Now the focus has shifted to the second method of prevention, eliminating the human reservoir from the lifecycle. Don't worry; no one is suggesting we start killing people that live in malaria hotspots. Eliminating the host involves preventing the mosquito bite in the first place.

One of the best prevention methods is mosquito netting. Hanging nets impregnated with insect repellants over sleeping areas can drastically reduce infections. There have been initiatives by humanitarian groups to provide more mosquito nets to poor, remote African villages in an attempt to reduce the impact of malaria. Using insect repellants and covering exposed skin can also reduce bites.

The third path for controlling malaria involves directly attacking the Plasmodium organism. This tactic involves giving people in malaria regions prophylactic drugs that kill the parasites or prevent them from becoming established in the body. Chloroquine is able to kill Plasmodium that have invaded the red blood cells of hosts, thus preventing further development of the parasite. Primaquine can kill the parasite in the bloodstream and destroy gametocytes. This makes infected hosts noninfectious if they are later bitten by mosquitoes.

People that plan to travel to malaria-impacted regions are usually given those drugs beforehand to prevent them from getting the disease. They are not foolproof, though. Oftentimes, the Plasmodium in the liver can avoid exposure to a fatal dose of the drugs. Symptoms can develop months after leaving the malaria zones and are often misdiagnosed. It is crucial that people who get sick after traveling to malaria regions tell their doctor about the trip to ensure appropriate testing and diagnosis.

Another problem with using drugs as preventatives is that they are expensive. The majority of people living in malaria hotspots are poor and can't afford the treatments. Making cheaper drugs isn't the answer, however. If the drugs become too widespread, drug-resistant Plasmodium develop, making prevention and treatment much more difficult across the board.

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