The greenery outside the window of the spring rain is getting more and more prosperous, the weather is getting hotter and hotter, and summer is coming, but the annoying flies and mosquitoes are also coming to the picture
Mosquitoes are not just "little vampires" that make people itch, according to research, mosquitoes spread more than 80 kinds of diseases, mainly Japanese encephalitis, malaria, filariasis, dengue fever and so on.
Today, we will focus on malaria as a disease.
"Too Long to Watch" version:
1. In 2019, in 87 countries, there were an estimated 229 million cases of malaria and 409 000 malaria-related deaths
2. At present, there are five kinds of malaria parasites that can infect people, namely Plasmodium falciparum, Plasmodium vivax, Plasmodium vivax, Plasmodium oval, Plasmodium trinadiosa and Plasmodium Nord's malaria, of which Plasmodium falciparum and Plasmodium Vivax are the most harmful
3. Symptoms of malaria usually appear 10-15 days after mosquito bite infection, but may also occur months or even years later
4. If you are unfortunate enough to be infected with malaria, early detection and early treatment will shorten the disease and avoid death. Most patients improve after 24 to 48 hours of early treatment, but fever with falciparum malaria can last up to 5 days
5. The best way to prevent malaria is to prevent mosquitoes and kill mosquitoes. In addition, considering that malaria is also transmitted through blood transfusions, it is also necessary to prohibit malaria patients from participating in blood donation, and there is currently no vaccine to prevent malaria
<h1 class="pgc-h-arrow-right" data-track="11" > ● Half of the world's population is at risk of malaria ●</h1>
Although the incidence of malaria in our country has decreased significantly in recent years, from 2017 to 2020, there have been no local primary malaria cases reported for nearly four consecutive years, and in November 2020, a national certification for malaria elimination was officially applied to WHO.
Malaria elimination certification is WHO's official recognition of a country's malaria-free status. WHO issues a certificate when a country proves that the terrestrial malaria chain has been interrupted across the country for at least the past three consecutive years. In addition to disruptions in the chain of transmission, the country must also demonstrate its ability to prevent re-transmission.
In the past 20 years, 11 countries have been certified malaria-free: United Arab Emirates (2007), Morocco (2010), Turkmenistan (2010), Armenia (2011), Sri Lanka (2016), Kyrgyzstan (2016), Paraguay (2018), Uzbekistan (2018), Algeria (2019), Argentina (2019) and El Salvador (2021).
(Source: 123RF)
However, malaria still places a heavy burden on global diseases. In 2019, in 87 countries, there were an estimated 229 million malaria cases and 409 000 malaria-related deaths, according to WHO data. Children under the age of five are the most vulnerable to malaria: in 2019, they accounted for 67% (274 000) of all malaria deaths globally.
Nearly half of the world's population is at risk of malaria in 2019, and while the majority of malaria cases and deaths occur in sub-Saharan Africa, there are also risks in Southeast Asia, the Eastern Mediterranean, the Western Pacific, and the Americas (be more careful when traveling to these regions).
<h1 class="pgc-h-arrow-right" data-track="18" > ●The initial symptoms of malaria are easily ignored●</h1>
Malaria is a protozoal infection that is transmitted by the bite of a female mosquito carrying the parasite. In rare cases, infection can be transmitted from an infected mother to her fetus, through transfusions of contaminated blood and transplantation of contaminated organs, or through sharing needles with people who have had malaria.
There are currently five species of Plasmodium malariae that can infect humans, namely Plasmodium falciparum, Plasmodium vivax, Plasmodium oval, Plasmodium trichophyllum and Plasmodium Nords.
Plasmodium nords is an emerging pathogen in Southeast Asia, and its transmission pattern is still under study. Plasmodium falciparum and Plasmodium vivax are the most harmful.
In 2018, Plasmodium falciparum caused 99.7% of estimated malaria cases in the WHO African Region, 50% of cases in the South-East Asia Region, 71% of cases in the Eastern Mediterranean Region and 65% of cases in the Western Pacific Region.
Plasmodium vivax is the main parasite that ravages the WHO Region of the Americas, causing 75% of malaria cases.
Plasmodium falciparum is the only plasmodium that can be fatal without treatment: patients without immunity may die a few days after symptoms appear.
Symptoms of malaria usually appear 10-15 days after mosquito bite infection, but may not develop until months or even years later. However, if it is an infection caused by a blood transfusion or shared needle, or congenital malaria, there is no incubation period and delayed recurrence.
The initial symptoms of all malaria are similar:
Chills and fever: as infected red blood cells rupture to release Plasmodium, patients typically experience severe chills, followed by an increase in body temperature above 40°C (104°F). Headaches, body pain, and nausea are also common. Fever usually decreases after a few hours and sweating profusely appears.
Alternating hot and cold: At first, the fever time was unpredictable, but then gradually became regular. Plasmodium vivax and Plasmodium oval are spaced 48 hours apart and Plasmodium trinidae 72 hours apart, and fever caused by Plasmodium falciparum is often irregular but sometimes occurs every 48 hours.
Other symptoms: patients with progression of infection may present with splenomegaly, severe anaemia, and jaundice.
Organ damage: Vivax, ovate, and trinidad malaria usually do not damage vital organs and have a low mortality rate, with most of the causes of death being splenomegaly ruptured, but falciparum malaria is the most severe.
In falciparum malaria, infected red blood cells often stick to the walls of small blood vessels, blocking small blood vessels and causing damage to many organs, especially the brain (cerebral malaria), lungs, and kidneys.
Therefore, malaria is a disease that is not obvious when infected, the initial symptoms are easily ignored, and the consequences of misdiagnosis and treatment are serious, and if there is fever and accompanying symptoms after traveling or returning to malaria areas, parasitological diagnostic tests should be carried out in time.
If unfortunately infected with malaria, early detection and early treatment will shorten the condition and avoid death. Most patients improve after 24 to 48 hours of early treatment, but fever in falciparum malaria can last up to 5 days.
<h1 class="pgc-h-arrow-right" data-track="35" > ●How to prevent malaria? ●</h1>
Vector control is the main way to prevent and reduce the spread of malaria, in other words, the best way to prevent malaria is to prevent mosquitoes. In addition, given that malaria is also transmitted through blood transfusions, malaria patients are also prohibited from participating in blood donation. Vaccines to prevent malaria are still experimental.
Precautions for mosquitoes:
Clean up stagnant water to reduce mosquito breeding environment.
Spray indoors and outdoors with insecticide.
Install screens on windows and doors.
Hang a mosquito net soaked in benzylmethrin (medicine tent) on the bed.
Spray exposed skin with insect repellents containing diethyltoluamide (DEET).
Try to wear long-sleeved trousers in the evening and at dawn to reduce mosquito bites.
Caution should be taken when using insect repellents containing DEET:
Insect repellent as directed on the label should only be used to expose the skin and should be used sparingly around the ears (not to be used or sprayed on the eyes or mouth)
Wash your hands after use
Do not allow children to use insect repellent (adults should first apply mosquito repellent to their own hands and then gently apply it to their child's skin)
Mosquito repellent should be just enough to cover exposed parts of the body
Wash off the protective agent immediately after returning indoors
Unless otherwise stated on the product label, wash your clothes before wearing them again
Africa and South-East Asia are highly endemic areas of malaria, and if you travel to these places, you should take medication to prevent malaria after consulting a professional doctor. Preventive medication should be started before traveling, continued medication for the duration of your stay, and extended medication depends on the medication.
It is important to note that prophylactic medications reduce the risk of malaria infection but do not completely eliminate it, and that pregnant women should be cautious in travelling to areas where malaria is highly endemic, given that malaria is more harmful to pregnant women (placental involvement can lead to preterm, miscarriage, stillbirth or congenital infection).
Edit: Dr. Spring Rain
bibliography:
[1] Jigang Wang, Chengchao Xu, Yin Kwan Wong, et al. Preparedness is essential for malaria-endemic regions during the COVID-19 pandemic[J]. The Lancet. March 16, 2020.
[2] Michael B. Wells, Deborah J. Andrew,Louis H. Miller,Anopheles Salivary Gland Architecture Shapes Plasmodium Sporozoite Availability for Transmission,DOI: 10.1128/mBio.01238-19
[3] WHO,Malaria,https://www.who.int/news-room/fact-sheets/detail/malaria
[4] Notice of the National Health Commission, the Disease Control Bureau of the National Health Commission on carrying out the publicity activities of National Malaria Day 2020, 2020-03-29,
http://www.nhc.gov.cn/jkj/s5873/202003/67d4e4df478344cf82295bb1bef28105.shtml
Copyright notice: This article is the original manuscript, the copyright belongs to Dr. Chunyu, unauthorized reproduction is prohibited, authorization and cooperation matters please contact [email protected]