Malaria

Scientific studies (review articles) on the relationship between eradicating malaria and combating malnutrition in developing countries:
One swallow does not make a summer. A famous Dutch saying that could not be any more obvious. Just because one single scientific study about a certain topic makes certain claims, it does not necessarily mean it is true. On the other hand, a review article (a collection of scientific studies on a certain topic) of randomized, placebo-controlled double blind clinical trials (RCTs) will answer the following question:
"Do taking dietary supplements make sense?" Yes for a positive conclusion and no for a negative conclusion.

One swallow does not make a summer. A famous Dutch saying that could not be any more obvious. Just because one single scientific study about a certain topic makes certain claims, it does not necessarily mean it is true. On the other hand, a review article (a collection of scientific studies on a certain topic) of cohort studies or case-control studies will answer the following question:
"Should I change my diet?".

1. High iron and low vitamin A status in individuals with malaria
2. Patients with severe malaria have a higher mean IL-10 level than non-severe malaria
3. IL-6 is a candidate marker for severe malaria
4. High CRP levels are a biomarker for early detection and monitoring of malaria severity
5. Maternal hookworm infection increases maternal anemia and coinfection with malaria
6. Asymptomatic malaria infection in Sub-Saharan African pregnant women is prevalent
7. Travel is an important risk factor for malaria infection in sub-Saharan Africa
8. Improved sanitation conditions reduce malaria infection among children of 0-59 months across sub-Saharan Africa
9. Transfusion-transmitted malaria is a significant transfusion-associated infection in Sub-Saharan Africa
10. Artemisinin resistance in South East Asia
11. Dihydroartemisinin-piperaquine reduces new infection and recrudescence on days 28 and 42 more than artemether-lumefantrine
12. Dihydroartemisinin-piperaquine should be first-line treatment of uncomplicated falciparum malaria in Ugandan children
13. AS-AQ provides a longer median duration of post-treatment prophylaxis than AL
14. A loading dose of tafenoquine alone is effective in preventing malaria in short-term travellers
15. Tafenoquine as a single dose is an effective alternative to Primaquine for prevention of recurrence of P vivax malaria
16. A high risk of P vivax parasitaemia after treatment for P falciparum infection in co-endemic regions
17. Increased risk of thrombocytopaenia in P. vivax malaria patients
18. 30 mg/kg chloroquine + primaquine prevent recurrent Plasmodium vivax malaria in children younger than 5 years
19. Artemether-lumefantrine as a first-line agent in the treatment of uncomplicated Plasmodium falciparum malaria in Ethiopia
20. Overall success of treatment of uncomplicated falciparum malaria in Sudan is 98%
21. Blood group O primiparous women are more susceptible to active placental P. falciparum infection
22. Sulfadoxine-pyrimethamine IPTp is not effective when prevalence of sextuple-mutant P falciparum parasite exceeds 37%
23. Artemisinin-based combination therapies should be treatment guidelines for uncomplicated falciparum malaria in pregnant women
24. Plasmodium falciparum malaria in pregnancy increases stillbirth risk
25. Coartem® is the drug for treatment of uncomplicated falciparum malaria for all age groups in Africa
26. ABT results in higher efficacy than QBT in the second and third trimester of pregnancy with uncomplicated falciparum malaria
27. 2 times daily for 5 days artemether-lumefantrine dosing for malaria treatment is needed in young children and pregnant women
28. Pregnant women with malnutrition and malaria infection are at increased risk of having a low birthweight compared to women with only 1 risk factor or none
29. First-trimester use of artemisinin derivatives is not associated with an increased risk of miscarriage or stillbirth compared to quinine
30. Malaria infection during pregnancy increases anemia risk in Ethiopia
31. Pregnancy-associated malaria increases preterm birth and low birth weight
32. Use of DP for IST of malaria is not superior to IPT‐SP
33. Monthly dihydroartemisinin-piperaquine appears well tolerated and effective for intermittent preventive treatment for malaria
34. Atovaquone/proguanil therapy is comparable in efficacy to ACT used in treating uncomplicated malaria
35. Insecticide-treated nets reduce malaria risk
36. Ultrasensitive malaria rapid diagnostic tests have higher sensitivity than conventional malaria rapid diagnostic tests
37. Self-reported ITN use represents a 13.6% overestimation relative to objectively measured ITN use for malaria prevention
38. Long-lasting insecticidal net use reduces risk of malaria with 56%
39. Individual bed net use might reduce risk of malaria
40. Insecticide-treated nets are the most effective measure for malaria prevention
41. Primaquine's transmission-blocking effects are achieved with 0.25 mg/kg primaquine
42. Primaquine reduces malaria-related anaemia at day 42
43. Glucose-6-Phosphate Dehydrogenase deficiency reduces uncomplicated malaria risk in African countrie

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• Malaria is a life-threatening disease. However, malaria is preventable and curable.
• Malaria occurs in nearly 100 countries worldwide.  
• The name malaria derived from “mal aria”, Medieval Italian for bad air. This idea came from the Ancient Romans who thought that this disease came from the horrible fumes in the swamps.
• Malaria parasites have been with us since the dawn of time. They probably originated in Africa (along with mankind) and fossils of mosquitoes up to 30 million years old, show that the malaria vector, the malaria mosquito, was present well before the earliest history.
• Hippocrates, a physician born in ancient Greece, today regarded as the "Father of Medicine", was the first to describe the manifestations of the disease and relate them to the time of year and to where the patients lived.
• For thousands of years, traditional herbal remedies have been used to treat malaria. The first effective treatment for malaria came from the bark of cinchona tree, which contains quinine.
• The first recorded treatment of malaria dates back to 1600, when the bitter bark of the Cinchona tree in Peru was used by the native Peruvian Indians.
  By 1649, the bark was available in England, as "Jesuits powder," so that those suffering from "agues" might benefit from the chemical substance quinine, which it contained.
  Not until 1889 was the protozoal (single celled parasite) cause of malaria discovered by Alphonse Laveran working in Algeria and only in 1897 was the Anopheles mosquito demonstrated to be the vector for the disease by Ronald Ross.
• There are 5 types of Malaria mosquito:
  1. Plasmodium falciparum is responsible for the majority of malaria deaths globally and is the most prevalent species in sub-Saharan Africa. Therefore, Plasmodium falciparum is the most lethal type.
  2. Plasmodium vivax is the second most significant species and is prevalent in Southeast Asia and Latin America. Some of the common symptoms of Plasmodium vivax are fatigue, diarrhoea, bouts of fever and chills. Approximately 60% of infections in India are caused by Plasmodium vivax.
  3. Plasmodium malariae and Plasmodium ovale represent only a small percentage of infections.
  4. Plasmodium ovale is the rarest type and mostly found in Ghana, Liberia, Nigeria and the tropical West African region.
  5. A fifth species Plasmodium knowlesi - a species that infects primates - has led to human malaria, but the exact mode of transmission remains unclear.
• Malaria is most commonly transmitted by an infected female Anopheles mosquito. The mosquito bite introduces the parasites from the mosquito's saliva into a person's blood. The parasites travel to the liver where they mature and reproduce.
• The signs and symptoms of malaria typically begin 8-25 days following infection. However, symptoms may occur later in those who have taken antimalarial medications as prevention.
• Malaria infection is usually confirmed by the microscopic examination of blood films or by antigen-based rapid diagnostic tests (RDT).
• Malaria causes symptoms that typically include fever, tiredness, vomiting and headaches. In severe cases it can cause yellow skin, seizures, coma or death.
• Malaria causes a reduction in haemoglobin levels.
• In 2018, there were an estimated 405,000 malaria deaths worldwide. Children aged under 5 years are the most vulnerable group affected by malaria. In 2018, they accounted for 67% of all malaria deaths worldwide.
• In 2018, an estimated 228 million cases of malaria occurred worldwide, with 93% of these cases occurring in the WHO Africa Region.
• Total funding for malaria control and elimination reached an estimated US$ 3.1 billion in 2017. Contributions from governments of endemic countries amounted to US$ 900 million, representing 28% of total funding.
• Countries that have achieved at least 3 consecutive years of 0 local cases of malaria are eligible to apply for the WHO certification of malaria elimination.
  In recent years, 9 countries have been certified by the WHO Director-General as having eliminated malaria: United Arab Emirates (2007), Morocco (2010), Turkmenistan (2010), Armenia (2011), Maldives (2015), Sri Lanka (2016), Kyrgyzstan (2016), Paraguay (2018) and Uzbekistan (2018).
• Malaria is a leading cause of death for children under five years of age in sub-Saharan Africa, killing a child every 60 seconds and posing a deadly threat to pregnant women.
• Intermittent preventive therapy or intermittent preventive treatment (IPT) is a public health intervention aimed at treating and preventing malaria episodes in infants (IPTi), children (IPTc), schoolchildren (IPTsc) and pregnant women (IPTp).
• The Global Technical Strategy for Malaria 2016-2030 was adopted by the World Health Assembly in May 2015. It provides a comprehensive framework to guide countries in their efforts to accelerate progress towards malaria elimination. The Global Technical Strategy for Malaria 2016-2030 sets the target of reducing global malaria incidence and mortality rates by at least 90% by 2030.
• Malaria is a top priority of the Bill & Melinda Gates Foundation.
• Bill Gates has said that he thinks global eradication of malaria is possible by 2040.
• Currently, there are 14 antimalarial treatment options:
  1. artemether-lumefantrine (AL);
  2. artemisinin-piperaquine;
  3. artesunate-amodiaquine (AS-AQ);
  4. artesunate-mefloquine (ASMQ);
  5. artesunate-chloroquine;
  6. artesunate-mefloquine home treatment;
  7. artesunate-mefloquine 2-day course;
  8. artesunate plus sulfadoxine-pyrimethamine;
  9. chloroquine;
  10. dihydroartemisinin-piperaquine (DHP);
  11. dihydroartemisinin-piperaquine home treatment;
  12. dihydroartemisinin-piperaquine 4-day course;
  13. dihydroartemisinin-piperaquine and;
  14. added artesunate and sulfadoxine-pyrimethamine.