Malaria continues to remain a global health concern even today. As per WHO’s ‘World malaria report’, there were 245 million cases of the disease in 2021; of these, more than six lakh succumbed to the infection.
A vector-borne infection caused by parasite plasmodium, malaria is spread through infected female Anopheles mosquitoes.
The highest malaria burden is seen in Africa. In 2019, the world’s first malaria vaccine — RTS,S/AS01 (or RTS,S) — was used in Kenya. In the past four years, over 1.4 million children have been jabbed with the vaccine in Africa, according to WHO. The vaccine, currently given only to children, is said to be a game-changer for malaria eradication.
According to Dr Netto George Mundadan, assistant professor, department of infectious diseases, GMC Kottayam, Kerala, malaria vaccines are given in the endemic regions in Africa to children above the age of five months in a schedule of four doses.
Does India need a malaria vaccine?
India had 1.7 lakh cases of malaria in 2022, as per data from the National Vector Borne Disease Control Programme. The highest number was from West Bengal (40,563 cases), followed by Chhattisgarh, Odisha, Jharkhand and Maharashtra. Of the 64 total fatalities, 25 were from Maharashtra.
Experts, however, say the incidence of malaria is declining in India.
“Only a few states in India have a high burden of malaria,” says Dr Mundanan. “In other parts of the country, indigenous cases are fewer. Hence, there’s no need to introduce malaria vaccination for the whole of country — covering the entire country with an immunisation programme is futile. Maybe the endemic places can be taken up for a pilot project.”
According to Dr Aniket Mule, consultant, internal medicine, Wockhardt Hospitals, Mira Road, Mumbai, India has more cases of dengue than of malaria — approximately 20 cases of dengue for every case of malaria. “Compared with the cases we were seeing five years ago, there has definitely been a 20% reduction in the number of cases [of malaria],” he says.
Dr Mule adds that rapid anti-malaria detection kits have made diagnosis faster. Advanced medicines and early diagnosis have ensured mortality due to malaria is very low.
Symptoms of malaria
Dr Mule lists the following as typical symptoms of malaria:
- High-grade fever with chills
- Joint pain
- Rashes
- Body ache
An individual must immediately consult a doctor and follow the treatment with prescribed medication when the typical symptoms of malaria are seen.
Complicated cases of malaria may lead to convulsions, altered mental status, unconsciousness and blood in the urine.
“There can also be bleeding once the platelets decline,” says Dr Mule, adding that the decline of platelets is commonly seen in both dengue and malaria.
Dr Mule adds that he gets more cases from the peripheries of Mumbai compared with the city centre.
In cases of malaria, high-grade fever is typically associated with periodicity, says Dr Mundanan. “A person may have high-grade fever for five to six hours one day, and then it subsides by sweating,” he says. “There may be no fever the next day [but] it may repeat on the third day.”
He adds that two to three malaria cases are seen in his medical college every week and most of the infected are migrant workers.
The most widely seen species of malaria are Plasmodium falciparum and Plasmodium vivax. “While Odisha largely has cases due to the malaria species Plasmodium falciparum, the case burden in northern India is linked to Plasmodium vivax,” he says. Dr Mundanan adds that in case of Plasmodium vivax, the dormant form of the pathogen (hypnozoite) stays in the liver for a long time and can reactivate the infection at some point in life.”
Treatment for malaria is a 14-day regime, and adherence is important, say doctors.
How to prevent malaria and mosquito bites
Mosquito-control measures — such as the use of mosquito nets and mosquito repellents — are a must for malaria prevention, says Dr Mule.
Dr Mundanan adds that environmental measures to prevent mosquito breeding — such as removing stagnant water from trash cans — are also essential. “Bed nets are most effective in mosquito prevention, apart from fogging and the use of Gambusia fish in freshwater domains (as it feeds on mosquito larvae).”
Dr George warns against the use of mosquito coils as they can be a cause of fire hazards. Moreover, their smoke is harmful to the lungs.
Takeaways
- Malaria, a vector-borne infection caused by the bite of the female Anopheles mosquito, remains a matter of global concern.
- RTS,S, the first malaria vaccine, was given in Kenya in 2019. Since then, more than four million children in Africa have been jabbed against the infection.
- Malaria is not contagious and does not spread from one person to another.
- Doctors says the typical symptoms of malaria — such as high-grade fever with chills, joint pain, rashes and body ache — must not be ignored.
