Malaria

From: https://en.wikipedia.org/wiki/Malaria

Malaria is a mosquito-borne infectious disease of humans and other animals caused by parasitic protozoans (a group of single-celled microorganism) belonging to the genus Plasmodium.[1]

Malaria causes symptoms that typically include fever, fatigue, vomiting and headaches. In severe cases it can cause yellow skin, seizures, coma or death.[2]

The disease is transmitted by the biting of mosquitoes, and the symptoms usually begin ten to fifteen days after being bitten. If not appropriately treated, people may have recurrences of the disease months later.[1] In those who have recently survived an infection, re-infection typically causes milder symptoms. This partial resistance disappears over months to years if the person has no continuing exposure to malaria.[2] The disease is transmitted most commonly by an infected female Anopheles mosquito. The mosquito bite introduces the parasites from the mosquito's saliva into a person's blood.[1] The parasites travel to the liver where they mature and reproduce. Five species of Plasmodium can infect and be spread by humans.[2] Most deaths are caused by P. falciparum because P. vivax, P. ovale, and P. malariae generally cause a milder form of malaria.[1][2] The species P. knowlesi rarely causes disease in humans.[1] Malaria is typically diagnosed by the microscopic examination of blood using blood films, or with antigen-based rapid diagnostic tests.[2] Methods that use the polymerase chain reaction to detect the parasite's DNA have been developed, but are not widely used in areas where malaria is common due to their cost and complexity.[3]

The risk of disease can be reduced by preventing mosquito bites by using mosquito nets and insect repellents, or with mosquito-control measures such as spraying insecticides and draining standing water.[2]

Several medications are available to prevent malaria in travellers to areas where the disease is common. Occasional doses of the medication sulfadoxine/pyrimethamine are recommended in infants and after the first trimester of pregnancy in areas with high rates of malaria. Despite a need, no effective vaccine exists, although efforts to develop one are ongoing.[1] The recommended treatment for malaria is a combination of antimalarial medications that includes an artemisinin.[1][2] The second medication may be either mefloquine, lumefantrine, or sulfadoxine/pyrimethamine.[4] Quinine along with doxycycline may be used if an artemisinin is not available.[4]

It is recommended that in areas where the disease is common, malaria is confirmed if possible before treatment is started due to concerns of increasing drug resistance. Resistance among the parasites has developed to several antimalarial medications; for example, chloroquine-resistant P. falciparum has spread to most malarial areas, and resistance to artemisinin has become a problem in some parts of Southeast Asia.[1]

The disease is widespread in the tropical and subtropical regions that exist in a broad band around the equator.[2] This includes much of Sub-Saharan Africa, Asia, and Latin America. Malaria is commonly associated with poverty and has a major negative effect on economic development.[5][6] In Africa it is estimated to result in losses of US$12 billion a year due to increased healthcare costs, lost ability to work, and effects on tourism.[7] The World Health Organization reports there were 198 million cases of malaria worldwide in 2013.[8][9] This resulted in an estimated 584,000 to 855,000 deaths, the majority (90%) of which occurred in Africa.[8][10]

Complications

Malaria has several serious complications. Among these is the development of respiratory distress, which occurs in up to 25% of adults and 40% of children with severe P. falciparum malaria. Possible causes include respiratory compensation of metabolic acidosis, noncardiogenic pulmonary oedema, concomitant pneumonia, and severe anaemia. Although rare in young children with severe malaria, acute respiratory distress syndrome occurs in 5–25% of adults and up to 29% of pregnant women.[15] Coinfection of HIV with malaria increases mortality.[16]

Renal failure is a feature of blackwater fever, where hemoglobin from lysed red blood cells leaks into the urine.[12]

Infection with P. falciparum may result in cerebral malaria, a form of severe malaria that involves encephalopathy. It is associated with retinal whitening, which may be a useful clinical sign in distinguishing malaria from other causes of fever.[17]

Splenomegaly, severe headache, hepatomegaly (enlarged liver), hypoglycemia, and hemoglobinuria with renal failure may occur.[12]

Complications may include spontaneous bleeding and coagulopathy. May cause shock (algid malaria).[18]

Malaria in pregnant women is an important cause of stillbirths, infant mortality, abortion and low birth weight,[19] particularly in P. falciparum infection, but also with P. vivax.[20]

Classification

Malaria is classified into either "severe" or "uncomplicated" by the World Health Organization (WHO).[3] It is deemed severe when any of the following criteria are present, otherwise it is considered uncomplicated.[51]

• Decreased consciousness
• Significant weakness such that the person is unable to walk
• Inability to feed
• Two or more convulsions
• Low blood pressure (less than 70 mmHg in adults and 50 mmHg in children)
• Breathing problems
• Circulatory shock
• Kidney failure or hemoglobin in the urine
• Bleeding problems, or hemoglobin less than 50 g/L (5 g/dL)
• Pulmonary oedema
• Blood glucose less than 2.2 mmol/L (40 mg/dL)
• Acidosis or lactate levels of greater than 5 mmol/L
• A parasite level in the blood of greater than 100,000 per microlitre (µL) in low-intensity transmission areas, or 250,000 per µL in high-intensity transmission areas Cerebral malaria is defined as a severe P. falciparum-malaria presenting with neurological symptoms, including coma (with a Glasgow coma scale less than 11, or a Blantyre coma scale greater than 3), or with a coma that lasts longer than 30 minutes after a seizure.[52]

Prognosis

When properly treated, people with malaria can usually expect a complete recovery.[97] However, severe malaria can progress extremely rapidly and cause death within hours or days.[98] In the most severe cases of the disease, fatality rates can reach 20%, even with intensive care and treatment.[3]

Over the longer term, developmental impairments have been documented in children who have suffered episodes of severe malaria.[99]

Chronic infection without severe disease can occur in an immune-deficiency syndrome associated with a decreased responsiveness to Salmonella bacteria and the Epstein–Barr virus.[100]

During childhood, malaria causes anemia during a period of rapid brain development, and also direct brain damage resulting from cerebral malaria.[99] Some survivors of cerebral malaria have an increased risk of neurological and cognitive deficits, behavioural disorders, and epilepsy.[101] Malaria prophylaxis was shown to improve cognitive function and school performance in clinical trials when compared to placebo groups.[99]

History

Although the parasite responsible for P. falciparum malaria has been in existence for 50,000–100,000 years, the population size of the parasite did not increase until about 10,000 years ago, concurrently with advances in agriculture[118] and the development of human settlements. Close relatives of the human malaria parasites remain common in chimpanzees. Some evidence suggests that the P. falciparum malaria may have originated in gorillas.[119]

References to the unique periodic fevers of malaria are found throughout recorded history, beginning in 2700 BC in China.[120] Hippocrates described periodic fevers, labelling them tertian, quartan, subtertian and quotidian.[121] The Roman Columella associated the disease with insects from swamps.[121] Malaria may have contributed to the decline of the Roman Empire,[122] and was so pervasive in Rome that it was known as the "Roman fever".[123] Several regions in ancient Rome were considered at-risk for the disease because of the favourable conditions present for malaria vectors. This included areas such as southern Italy, the island of Sardinia, the Pontine Marshes, the lower regions of coastal Etruria and the city of Rome along the Tiber River. The presence of stagnant water in these places was preferred by mosquitoes for breeding grounds. Irrigated gardens, swamp-like grounds, runoff from agriculture, and drainage problems from road construction led to the increase of standing water.[124]

The term malaria originates from Medieval Italian: mala aria—"bad air"; the disease was formerly called ague or marsh fever due to its association with swamps and marshland.[125] The term first appeared in the English literature about 1829.[121] Malaria was once common in most of Europe and North America,[126] where it is no longer endemic,[127] though imported cases do occur.[128]
Scientific studies on malaria made their first significant advance in 1880, when Charles Louis Alphonse Laveran—a French army doctor working in the military hospital of Constantine in Algeria—observed parasites inside the red blood cells of infected people for the first time. He therefore proposed that malaria is caused by this organism, the first time a protist was identified as causing disease.[129] For this and later discoveries, he was awarded the 1907 Nobel Prize for Physiology or Medicine. A year later, Carlos Finlay, a Cuban doctor treating people with yellow fever in Havana, provided strong evidence that mosquitoes were transmitting disease to and from humans.[130] This work followed earlier suggestions by Josiah C. Nott,[131] and work by Sir Patrick Manson, the "father of tropical medicine", on the transmission of filariasis.[132]

In April 1894, a Scottish physician Sir Ronald Ross visited Sir Patrick Manson at his house on Queen Anne Street, London. This visit was the start of four years of collaboration and fervent research that culminated in 1898 when Ross, who was working in the Presidency General Hospital in Calcutta, proved the complete life-cycle of the malaria parasite in mosquitoes. He thus proved that the mosquito was the vector for malaria in humans by showing that certain mosquito species transmit malaria to birds. He isolated malaria parasites from the salivary glands of mosquitoes that had fed on infected birds.[133] For this work, Ross received the 1902 Nobel Prize in Medicine. After resigning from the Indian Medical Service, Ross worked at the newly established Liverpool School of Tropical Medicine and directed malaria-control efforts in Egypt, Panama, Greece and Mauritius.[134] The findings of Finlay and Ross were later confirmed by a medical board headed by Walter Reed in 1900. Its recommendations were implemented by William C. Gorgas in the health measures undertaken during construction of the Panama Canal. This public-health work saved the lives of thousands of workers and helped develop the methods used in future public-health campaigns against the disease.[135]

The first effective treatment for malaria came from the bark of cinchona tree, which contains quinine. This tree grows on the slopes of the Andes, mainly in Peru. The indigenous peoples of Peru made a tincture of cinchona to control fever. Its effectiveness against malaria was found and the Jesuits introduced the treatment to Europe around 1640; by 1677, it was included in the London Pharmacopoeia as an antimalarial treatment.[136] It was not until 1820 that the active ingredient, quinine, was extracted from the bark, isolated and named by the French chemists Pierre Joseph Pelletier and Joseph Bienaimé Caventou.[137][138]

Quinine become the predominant malarial medication until the 1920s, when other medications began to be developed. In the 1940s, chloroquine replaced quinine as the treatment of both uncomplicated and severe malaria until resistance supervened, first in Southeast Asia and South America in the 1950s and then globally in the 1980s.[139] Artemisinins, discovered by Chinese scientist Tu Youyou and colleagues in the 1970s from the plant Artemisia annua, became the recommended treatment for P. falciparum malaria, administered in combination with other antimalarials as well as in severe disease.[140]

Plasmodium vivax was used between 1917 and the 1940s for malariotherapy—deliberate injection of malaria parasites to induce fever to combat certain diseases such as tertiary syphilis. In 1927, the inventor of this technique, Julius Wagner-Jauregg, received the Nobel Prize in Physiology or Medicine for his discoveries. The technique was dangerous, killing about 15% of patients, so it is no longer in use.[141]

The first pesticide used for indoor residual spraying was DDT.[142] Although it was initially used exclusively to combat malaria, its use quickly spread to agriculture. In time, pest control, rather than disease control, came to dominate DDT use, and this large-scale agricultural use led to the evolution of resistant mosquitoes in many regions. The DDT resistance shown by Anopheles mosquitoes can be compared to antibiotic resistance shown by bacteria. During the 1960s, awareness of the negative consequences of its indiscriminate use increased, ultimately leading to bans on agricultural applications of DDT in many countries in the 1970s.[67] Before DDT, malaria was successfully eliminated or controlled in tropical areas like Brazil and Egypt by removing or poisoning the breeding grounds of the mosquitoes or the aquatic habitats of the larva stages, for example by applying the highly toxic arsenic compound Paris Green to places with standing water.[143]

Malaria vaccines have been an elusive goal of research. The first promising studies demonstrating the potential for a malaria vaccine were performed in 1967 by immunizing mice with live, radiation-attenuated sporozoites, which provided significant protection to the mice upon subsequent injection with normal, viable sporozoites. Since the 1970s, there has been a considerable effort to develop similar vaccination strategies within humans.[144]

Statistics

Malaria is one of the most severe public health problems worldwide. It is a leading cause of death and disease in many developing countries, where young children and pregnant women are the groups most affected. According to the World Health Organization’s World Malaria Report 2013 and the Global Malaria Action Plan
• 3.4 billion people (half the world’s population) live in areas at risk of malaria transmission in 106 countries and territories In 2012, malaria caused an estimated 207 million clinical episodes, and 627,000 deaths. An estimated 91% of deaths in 2010 were in the African Region.

Malaria is a deadly mosquito-borne disease that affects millions each year in Africa and around the world: - See more at: http://www.netsforlifeafrica.org/malaria/malaria-statistics#sthash....

• Over half a million (627, 000) people die from malaria each year, mostly children younger than five years old.
• There are an estimated 207million cases of malaria each year.
• Although the vast majority of malaria cases occur in sub-Saharan Africa, the disease is a public-health problem in more than 109 countries in the world, 45 of which are in Africa.
• 90% of all malaria deaths occur in sub-Saharan Africa.
• Malaria costs an estimated $12 billion in lost productivity in Africa.
• When insecticide-treated nets are used properly by three-quarters of the people in a community, malaria transmission is cut by 50%, child deaths are cut by 20%, and the mosquito population drops by as much as 90%.
• It is estimated that less than 5% of children in sub-Saharan Africa currently sleep under any type of insecticide-treated net.
• It is estimated that a child dies every minute of malaria

From: World Health Organization, 10 Facts on Malaria

• About 3.2 billion people – almost half of the world's population – are at risk of malaria. In 2013, there were about 198 million malaria cases (with an uncertainty range of 124 million to 283 million) and an estimated 584 000 malaria deaths (with an uncertainty range of 367 000 to 755 000).
• Increased prevention and control measures have led to a reduction in malaria mortality rates by 47% globally since 2000 and by 54% in the WHO African Region.
• In 2013, 90% of the world’s malaria deaths occurred in Africa and over 430 000 African children died before their fifth birthdays.
• Early diagnosis and treatment of malaria reduces disease and prevents deaths. It also contributes to reducing malaria transmission. Access to diagnostic testing and treatment should be seen not only as a component of malaria control but as a fundamental right of all populations at risk.
• Parasite resistance to artemisinin, the core compound in WHO-recommended combination treatments for uncomplicated malaria, has been detected in 5 countries of south east Asia: Cambodia, Laos, Myanmar, Thailand and Viet Nam. However, artemisinin-based combination therapies remain effective in almost all settings, as long as the partner drug in the combination is locally effective.
• These nets provide personal protection against mosquito bites. They can be used as protection for people most at risk of malaria, such as young children and pregnant women in high malaria transmission areas. The nets are effective for 3-5 years, depending on the model and conditions of use. In 2013, an estimated 49% of the population at risk in Africa had access to a bed net.
• Pregnant women are at high risk of dying from the complications of severe malaria. Malaria is also a cause of spontaneous abortion, premature delivery, stillbirth and severe maternal anaemia, and is responsible for about one third of preventable low-birth-weight babies. WHO recommends intermittent preventive treatment for pregnant women living in areas of high malaria transmission.
• People living in the poorest countries are the most vulnerable to malaria. In 2013, 90% of all malaria deaths occurred in the WHO African Region, mostly among children under 5 years of age.

Famous People Who Died of Malaria

(69 people listed, some with short bios) '''from:''' http://www.ranker.com/list/famous-people-who-died-of-malaria/reference

• George Gordon Byron, British poet (1788-1824)
• Oliver Cromwell, English military & political leader & Lord Protector of the Commonwealth of England, Scotland & Ireland (1599-1658)
• Vasco da Gama, Portuguese explorer
• David Livingstone, Medical missionary & explorer in Africa (1813-1873)
• Fausto Coppi, international cyclist (1919-1960)
• Josef Fessel, German Bohemian forester & inventor (1793-1857)
• Henry VI, Holy Roman Emperor, King of Germany (1165-1197)
• Otto III, Holy Roan Emperor, member of the Ottonian dynasty & King of Germany in 983 (980-1002)
• Pope Urban VII (1521-1590)
• Prince Henry of Battenberg (1858-1896)
• Trevor Madondo, Zimbabwean cricketer (1976-2001)
• Joe Cassidy, American Major League Baseball player from Chester, Pennsylvania (1883-1906)
• Sarah Knox Taylor (1814-1835)
• Charlotte Canning, Countess Canning (1817-1861)

From: Cheryl Cole, JFK, Genghis Khan and the top 10 famous people to be struck down with Malaria (but survived)

• Cheryl Cole
• Erroll Flynn
• Ross Kemp
• Genghis Khan (need further research as to whether he did or didn't die from Malaria/pscoggin)
• Michael Essien
• Sir David Attenborough
• Lord Nelson
• Christopher Columbus
• Michael Caine
• John F Kennedy
• Mother Teresa

Additional Links:

• Factsheet on the World Malaria Report 2014
• [http://www.theguardian.com/news/datablog/2012/feb/03/malaria-deaths...]
• [http://www.unicef.org/health/index_malaria.html]
• Centers for Disease Control and Prevention
• [http://www.cdc.gov/malaria/malaria_worldwide/impact.html]
• NetsForLife Malaria Statistics
• History of the discovery of the malaria parasites and their vectors
• Malaria History
• When was malaria first discovered and by whom? How is the disease transmitted? What are its effects?
• The Free Dictionary By Farlex
• Medicine in the Old West: A History, 1850-1900, By Jeremy Agnew page 67-69

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