Trends and Treatment of Malaria - Case Study Example

Epidemiology of Malaria Epidemiology of Malaria According to the world health organization statistical findings, malaria is responsible for more than 650,000 mortalities annually. In 2010, some research findings held that malaria is responsible for more than 1.2 million fatalities. The majority of the incidences of malaria attacks and deaths are among the children under the age of five and expectant mothers. The prevalence of malaria is more common in the tropical regions where more than 3 million of the population in the area are exposed to malaria annually. This makes people in the tropical areas to be at a higher risk of contracting malaria. WHO statistical figures indicates that in 2012, approximately 207 million people developed signs and symptoms of malaria in 2012, with the majority of them, confirmed to be infected (Cotter et al. 2013, pp.900–911). Nevertheless, beginning 2000, 34 countries have managed to fight malaria effectively, thus reducing the incidence of the disease by about 85% over a period of one decade. In the year 2004, the mortality rate of malaria experienced a record peak of 1.82 million, which ultimately dropped to 1.24 million in 2010. The bulk of malaria infection is still predominant in the sub-Sahara Africa. In accordance with the African health index, malaria is currently high in the equatorial region of the globe, in Asia, America and most parts of Africa (White et al. 2014, pp.723–735). Among the African countries, Ivory Coast, BukinaFaso, and Angola recorded the highest death rates per 100,000 of the population. However, a progressive decline in the prevalence rate of malaria has been observed in the recent years in Africa. The dramatic drop in the rate of malarial infections in the world has been associated with the wide use of insecticides, treated mosquito nets as well as antimalarial medications. The prevalence of malaria is high in the tropical and the subtropical regions due to the high rainfall levels thus forming ample breeding grounds for mosquitoes. Steady high temperatures and humidity in the tropical regions equally favour the breeding of mosquitoes in the tropical regions (Cotter et al. 2013, pp.900–911). According to the 2013 world malaria report, 97 countries in the world have been determined to have an infection rate higher than 80%. These countries account for the highest mortality rate of malaria in the world. Nigeria and Democratic Republic of Congo, in particular, have a combined effect of causing approximately 40% of the total world malaria deaths making the transmission rate in the countries the highest respectively. Trends of Malaria Among the tropical conditions, malaria records as one of the highest spread diseases in the world. The extent of malarial infection ranges in nearly all the continents including Africa, Asia as well as Latin America. Basing on the WHO statistical reports, in 2012, an estimated population of 207 million people, contracted malaria with more than 0.5 million killed as a result of the infection. Of the infected people, more than half of them were children. From an economic point of view, malaria has an immense implication on the economy as it directly increases the health care cost. Additionally, on other sectors of the economy, malaria result in the loss of the labour force, depreciation on the number of tourism activities. The total global economic loss due to malaria is approximately USD 12 billion (White et al. 2014, pp.723–735). Systematic changes in the urban development, the use of natural resources, agricultural activities as well as food security have a significant influence on the nature of malarial infection and transmission with a remarkable change in the community and country’s dynamics. Climate change is a significant factor that is a contributor to the nature of malarial infection and transmission. However, the manner with which climate change contribute to malaria transmission is still a subject of on-going research. A wider awareness of the preventive measures towards malaria a well as the well-coordinated anti-malarial campaigns in the malaria prone areas is the reason for the significantly decreased level of malarial infections and mortality. Various governments throughout the world have taken an initiative of increasing funds towards malaria control thus making. Malarial regulation in the southern region of Africa including South Africa, Swaziland and Mozambique began in the 1980’s and has seen a significant drop in the rate of malarial infection in the region as well as the rate of malaria transmission. Additionally, the Horn of Africa has seen a significant drop in the rate of malarial infection especially in the countries like Ethiopia and Eritrea. The significant drop rate in the Horn of Africa has been due to the change in the procedure for malaria control in the region with the adoption of the current methods and techniques of mitigation in the malaria prone areas (Cotter et al. 2013, pp.900–911). Patterns of malaria Research findings indicate a relationship between the age of an individual and the intensity of malaria infection. However, several types of research are underway to develop an effective mechanism of malarial infection especially among the infants and the children under five years of age and the pregnant women. A malaria control strategy that is able to determine the groups that are at an increased risk of malarial attack would be crucial for the control of the disease among the most vulnerable members of the community (Bright & Winzeler 2013, pp.446–447.). However, literature sources indicate that over concentration and emphasis on the prevention of malaria among the children could result in a shift in the trend of the disease with the elderly being the new casualties of the malarial attack. Climate changes have been determined to be responsible for exacerbation of malarial attack. The elderly in the community are among the most vulnerable members thus neglect of the elderly in the fight against malaria infections could greatly disadvantage the group. Current intervention for treatment and control of malaria Nothing but Nets Operating on a philosophical statement of send and save a life, nothing by net is a global promotion set by the United Nations Foundation. The core initiative for the formation of the promotion drive was to create awareness and generate more resources for the prevention of malaria. The campaign is purposed to ensure that communities within the Sub-Saharan Africa regions- a region with the highest recorded mortality and morbidity, are supplied with insecticide-treated bed nets. The strategy of fighting malaria based on the use of nets was because nets have been found to be cheap and simple as well as offers high effectiveness in the prevention of mosquito bites. In collaboration with the United Nations, the nothing but nets operates by procuring, shipping and supplying the nets in a community-based approached, with the intention of reaching those communities that are affected by the shortage of mosquito nets as well as lack financial well-being to purchase nets for themselves. The distribution of these nets is conducted through a partnership with the ministry and departments of public health who have a better understanding of the communities and their needs. Targeted are the people who are at the highest risk of malaria infection in the internally displaced people, children, and pregnant mothers. Nevertheless, the proprieties of the organization shift in relation to different needs of different communities (White et al. 2014, pp.723–735). Analysis of the efficacy of the intervention According to the world health organization statistics, malaria is currently the world’s fifth-leading cause of mortality among the children and the refugees. However, the statistics of the deaths have greatly reduced as an initiative of vigorous campaigns against malaria. Nevertheless, the program has suffered challenges with the distribution of the nets in most African countries that are related to political disturbance and unrest that hinders the flow of the nets to the war-torn regions. Malaria No More This partnership was founded in the year 2006 by Peter Chernin and Raymond G. Chambers. The partnership has a global network and operates with associate groups in the United Kingdome, Canada, Japan, and Netherlands. The malaria no more partnership operates as a non-profit-making organization and relies on the contribution of the members as well as subsidies in undertaking the implementation process of eradicating malaria. Malaria No More partnership in association with similar groups allows for the local sponsorship groups to engage local support from the communities. Partnership with small groupings that have an already established network of the community makes it easy and efficient to reach the communities and implement the intervention plans. The organization has been successful in reaching out to 17 countries throughout different regions of the world and have been able to implement the malaria eradication process through the supply of insecticide-treated mosquito nets and other antimalarial medications. Additionally, the launch of power one operation in 2013 was aimed at providing speedy diagnostic tests as well as artemethisin based combination therapy as a means of reduction of the malaria toll on the children and the vulnerable members of the society. The partnership was formed with the key objective of controlling malaria through the provision of adequate health care. This was to be achieved through timely diagnosis; which was to be attained through Rapid diagnostic tests (RDTs) which would be crucial in the transformation of the health care system as well as acquisition of the in-depth skills in identification of and diagnosis of members of the society. A well-coordinated and structured system of early diagnosis of malaria enables members of the community to seek for early treatment interventions thus enabling them to prevent the disease burden in the community. Other than early diagnosis, treatment of the malaria cases in the community is a crucial undertaking in the process of controlling the rate of malarial infection in the community. In the current health care system in accordance with the partnership, the availability of Artemisinin-based combination therapies (ACTs) is a significant forward step in the management of malarial infection. Artemisinin-based combination therapies (ACTs) is currently the lead therapy in the management of malaria and through research works, it has been determined that the medication is efficient and effective in the control of malaria across the entire age trajectory. In child health care concern, Artemisinin-based combination therapies (ACTs) has the potentiality of reversing the death of children in relation to malaria when effectively and efficiently used within the required time frame (Bright & Winzeler 2013, pp.446–447.). Mosquito net provision is another of the strategy of the Malaria No More initiative. Through provision of mosquito nets especially in the malaria endemic regions, it would be easy to protect the community from the burden of malaria treatment as researches have proved that primary care is more economical in comparison to secondary care. The long-lasting insecticide-treated nets (LLINs) have been created to avert malaria by providing protection for at least two people per net from night-time mosquito bites, which is the peak time for transmission. Targeted insecticide spraying is another strategy that has been employed by the organization in control of malaria transmission and infection. Spraying that targets the indoor walls that will retain the effects of the spray for a longer time is effective in the regulation of mosquito existence in the human dwelling areas. Additionally, government funding is an important aspect of the fight and control of malarial infection, as it will provide an adequate amount of tools and mechanics necessary for the implementation of the malaria control strategies (Cotter et al. 2013, pp.900–911). The organization also identifies the importance of health education that targets the community as a means of controlling malaria infections and transmission. An appropriately articulated health education is capable of empowering the community to understand their health care needs thus will cooperate with the organization in the implementation of the interventions targeting the control of malaria. Challenges of the intervention Funding is the primary challenge in the implementation of the malaria no more strategies. Some governments have been relaxed in subsidizing the operations of the organization in their countries thus making the organization to be cash constrained. Additionally, being that the organization is operating under a non-profit making banner, it is difficult for it to finance its strategies without relying on external aid (Bright & Winzeler 2013, pp.446–447.). The roll back malaria campaign The roll back malaria campaign is a strategy of the world health organization through a partnership with the governments as well as a non-governmental organization responsible for health care initiatives with the agenda aiming malaria control. The Roll back malaria partnership entails organizations such as the WHO, UNICEF, UNDP and the World Bank. The campaign was launched in 1998 with an aim of delivery of a harmonized and targeted the antidote for the disease. The partnership was again restructured in 2006 in a change initiative process to enable the partnership to manipulate effectively the emerging challenges that hinder effective implementation of the strategies geared towards the eradication of the infection. The roll back malaria campaign is purposed to reducing the incidences of infections resulting from malaria as well as reduce mortality rates resulting from the disease. Working under the banner of the global malaria action plan, the partnership outlined two basic methods for control of malaria: 1. Scaling-up for impact (SUFI) therapeutic and preventive interventions 2. Establishing control over time. In 2008, the development of the millennium development goals was meant to pool resources and expertise to control of endemic diseases and malaria being one of such diseases formed key among the diseases that needed the intervention of the partnership (MDG Malaria, 2008). The Global Malaria Action Plan (GMAP) has the ultimate plan to ensure and facilitate a significant and continual decline of the malaria burden in the near future and at an ultimate eradication (World Health Organization 2013, pp. 6-29). The roll back malaria partnership in 2002 to encompass a number of partners across eight constituencies, consensual and multidimensional associates, nongovernmental organizations, community-based organizations, private citizens, and research and educational institutions. The structural mechanism of the roll back malaria partnership to ensure easy coordination of activities in the levels of the country, regionally as well as globally. The organization of the structure of the roll back malaria partnership was meant to reduce chances of structure overlap and division while attaining maximal disbursement of resources. In 2014, the development of the second global malaria plan of action had been the core goal and initiative of the roll back malaria partnership. The second malaria action plan (GMAP2) is meant to cover a period of ten years ranging from 20016 to 2025. The initiative is to develop structures that will ensure that by 2025, the world will be free from malaria. The second roll back malaria global plan of action will work through in cooperating a multidisciplinary and multidimensional structure that will synergize the functionality of the plan to facilitate the interventions for the eradication of malaria. The cooperation through multidisciplinary and multi-sectorial approach is significant especially in the current socioeconomic system of the world that is constrained by resources. Challenges of the intervention Leadership structure and the opinion differences among different selected and appointed leaders in the roll back malaria partnership has been the greatest setback in the achievement of the goals of the partnership. The leadership failure in the partnership resulted in the lack of confidence in the commissioners thus resulting in the restrictions or disapproval of the subsidies that are meant to finance the operations of the partnership (World Health Organization 2013, pp. 6-29). New Intervention Overview Over the past decade, clinical trials and research have made medical discovery responsible for saving lives that would have other wisely been claimed by malaria. With the preventive measures such as the use of mosquito nets, health education and the secondary measures such as the treatment of malaria using artemethasin, malaria deaths have been significantly reduced. The current medical concern is the ability of the Plasmodium parasite to develop a resistance against the antimalarial that have been commonly used in the market. Additionally, the mosquitoes have started to show a growing lack of susceptibility to available insecticides. The interplay of these two factors will make it difficult to control the rate of malarial infection in the community. The effectiveness of the insecticide-treated mosquito nets and the indoor spraying of the insecticides have been unquestionable viable in the control of mosquitoes, nevertheless, current research findings indicate the existence of a current strain of mosquitoes who have developed immunity to the insecticides thus making the approach ineffective in their control. The phenomenon of insecticide resistance among mosquitoes has been observed in sixty-four countries and is one of the greatest hindrances in the fight against malaria infection. In an effort to mitigate the resistance of mosquitoes to insecticides, the international vector control commission (IVCC) has developed four strategies to ensure effective application of mosquito control ie; Environmental control; Personal protection measures; Biological control and Chemical control. Nevertheless, the main strategy of the international vector control commission (IVCC) is the application of chemicals in the management of vectors. Additionally, the body is charged with the responsibility of finding the best way to deal with insecticide and disease resistance by synthesizing new and harder-hitting methods and pesticides that would be hard to resist in the conflict against malaria and vector-borne ailments. The body is currently undertaking research to look into the possible effective chemicals that can be used in the management of insecticide-resistant mosquito strains that have been reported in the 64 countries. Rational on intervention: objective and efficacy in the chosen population Resistance to a drug can be identified at an early stage. This is determined when the drug is active against one active ingredient but is significantly less viable when an insecticide with more than one active ingredient is used. Pyrethroids has been the benchmark drug in relation to the insecticides thus the development of a drug with more than three active ingredients but retains the effectiveness of pyrethroids would be a breakthrough in the control of the mosquitoes that have developed immunity to insecticides. The delay in development of a new drug for the management of mosquitoes has taken more than three decades, thus a development of an effective insecticide is crucial for the future control of the mosquitoes that have proven to be non-responsive to the conventional insecticides in the market. The need for a new kind of an effective insecticide is an urgent need that has to be attended to so as to defuse the “insecticide resistance’’ situation that has become a disaster waiting to happen. Malaria parasite vaccine Mode of action The plasmodium parasite acts by attacking the healthy red blood cells corpuscles and hide inside for nourishment and reproduction. Within seven days from entry, the Plasmodium parasites are mature enough, disintegrate, and spread, affecting other red blood cells with the continuation of the cycle. The plasmodium parasite results in lysis of the red blood cells hence rendering them ineffective in the transportation of gasses. A new innovative Nanotechnology has been developed as the control of the effects of Plasmodium parasite in the bloodstream; the technology uses the principle of Nano mimics to prevent the action of the parasite. The technology functions by mimicking the blood cells and disrupt the lifecycle of invading malaria parasites while containing the active substance with therapeutic effect; and in so doing, functions in a dual role by working as a drug and as a vaccine. The invading parasites would thus bind to the Nano mimics instead of the red blood cells thus disrupting their infective cycle. The ineffective parasites will then be reached by the body’s immune system, which will eliminate them from the body (World Health Organization 2013, pp. 6-29). Operation of Intervention Approval of the Nanotechnology intervention as a vaccine against malaria will enable the adoption of the intervention in the community vaccination drive. The publicity of the intervention will thus be achieved through establishment of awareness in hospitals, schools and homes making the vaccination program achieve its intended objective. Liaising with the local authority and community leaders will then be another significant step in ensuring that the vaccination process meets its target groups. However, before massive use of the vaccine, it would be necessary it is exposed to clinical trials. In the phase 1 of the clinical trials, a few clusters of individuals will be given the trial vaccine. Phase two of the trial will target individuals of specific identifiers such as a specific age group or gender to determine the effectiveness and the effects of the vaccine in relation to specific groups. The third clinical phase trial will involve the giving of the vaccine to a large group of people to determine the relative effectiveness and effects of the vaccine when different people are exposed to the vaccine. Evaluation of the intervention The use of Nano mimic vaccine will enable radical elimination of malaria more effectively. The application of the vaccine in childhood will thus help in reducing the disease burden in an individual throughout life. The use of the technology will equally cut the cost of the expensive apparatus like the mosquito nets and the insecticides that are sent to the remote areas for the control of malaria, thus the technology will offer a permanent solution to the control of malaria. Being that the vaccination process is a simple one; the acceptance rate of the vaccine will be high thus making it achieve a higher proportion of its objectives. The use of Nanotechnology vaccine will enable travellers and tourists to get vaccinated against malaria and other vector-borne diseases. The primary aim of vaccination is to eradicate malaria globally, thus help in the reduction of morbidity and mortality resulting from malarial infection. Reduction of malaria infections and deaths will ultimately reduce the disease burden in the society. Adjustment of government policies to include vaccines as part of the global drive against is crucial for the efforts in fighting against malaria (White et al. 2014, pp.723–735). Bibliography Bright, A.T. & Winzeler, E.A., 2013. Epidemiology: resistance mapping in malaria. Nature, 498, pp.446–447. Cotter, C. et al., 2013. The changing epidemiology of malaria elimination: new strategies for new challenges. Lancet, 382, pp.900–11. White, N.J. et al., 2014. Malaria. Lancet, 383, pp.723–35. World Health Organization, 2013. World Malaria Report 2013, Read More