Why Do So Many People Still Die of Malaria - Coursework Example

Course Work Malaria: Why Do So many People Still Die of Malaria? Introduction Historical evidences suggest that the history of malaria started from the very origin of mankind and have taken billions of human lives. Malaria is an infectious disease caused by a parasite called Plasmodium that affects the red blood cells. Generally, chills, pain, fever, and sweating are the main symptoms of malaria. Parasites in human blood were firstly identified by C. Laveran in 1880 and subsequently in 1889; R. Ross discovered the role played by mosquitoes in transmitting malaria. There are mainly four species of Plasmodium that cause malaria in which Plasmodium Falciparum is the most dangerous one. Recently, scientists discovered another dangerous species known as Plasmodium knowlesi which can also be life threatening. Medical practitioners opine that humans may get infected with more than one type of Plasmodium at a time. Although effective medicines have been developed for the treatment of this disease, any failure in timely diagnosis would make the disease dreadful. Why do so many people still die of malaria? In the opinion of Rietveld & Schlagenhauf (2008, p.214), malaria produces more complications in pregnant women and young children because these groups are more vulnerable to malaria. As mentioned above, malaria includes different categories among which cerebral malaria or brain malaria is the most dreadful one. Cerebral malaria produces notable changes in the mental status of the people affected and sometimes it may lead the patients to a coma stage. The mortality rate for this disease is 25-50% and an affected person would certainly die in 24-72 hours if he/she does not get proper treatment. The most horrible nature of this disease is that 15-20% victims of cerebral malaria die even if they are given medicine right time. The mortality rate of cerebral malaria still rises since medical science has not well identified the cause of this disease yet (Physorg.com). According to Bhatia (2002, p. 98), Blackwater fever is another complication of malaria in which red blood cells break and release hemoglobin directly into the blood. Progressively, this released hemoglobin reaches urine and it makes the urine very dark in appearance. If the patient does not get proper care in this condition, he may suffer from kidney failure too. Unfortunately, effective remedial measures to hemolytic crises of this disease have not been discovered yet. The rapid annihilation of red blood cells leads to other issues like hemoglobinemia, hemoglobinuria, and anuria and even death. Likewise, Pulmonary edema is an awful situation arising out of acute falciparum malaria and there is 80% possibility for associated deaths. This disease is characterized by the accumulation of fluid in lungs that damages the respiratory system of the affected person. We know that respiration is the inevitable part in the organic functioning of the human body because it is the process that provides sufficient oxygen to whole body cells. Doctors assert that pulmonary edema produces rapid deaths as compared to other related cases. Sometimes, very low blood sugar is reflected as the feature of malaria and it is a catastrophic complication of malaria as it may lead the affected person to a stage of coma. Some people may have large number of parasites in their blood; in such persons, the blood sugar level falls dangerously. In the opinion of Cotter (2001, p.39), hemolysis, which is the phenomenon of red blood cell breakage, is the direct cause of Blackwater fever. It also causes some horrible diseases such as intense jaundice and symptoms of anemia. Coagulopathy, also called bleeding disorders, is also a medical condition in which human body loses its ability to stop bleeding. It is observed that bleeding diseases sometimes appear as a result of malaria and gradually leads the affected person to death. The above described are the most complicated sides of malaria that often seem fatal in most of the cases. Social implications of malaria In addition to its catastrophic complications, malaria gives rise to a sequence of social issues. World Health Organization (2005, p. 149) clearly indicates that Malaria can be averted to a great extent if people are well aware of the significance of preventive methods. In contrast, it is often observed that some underdeveloped communities do not have proper information about the horridness of malaria and hence they are more prone to this disease. According to World Health Organization, malaria affects African countries more especially, children as they are the most vulnerable segment. “In Africa, a child dies every 45 seconds of malaria, the disease accounts for 20% of all childhood deaths” (Media Centre, WHO). The researchers have indicated that children survived from malaria show weaker physical and intellectual development. Malaria may also cause anaemia which is the central cause ‘contributing to maternal deaths in pregnancy and stillbirths’ (Biovision). Moreover, the undiagnosed malaria would raise difficulties to healthcare organisations in developing effective prevention policies. School absenteeism is another social issue associated with malaria and this will seriously impinge on the education sector of the country (Biovision). The spread is highly rampant during rainy season; and since it is a time of intense rural activity, malaria makes the rural people’s life situations worse. In addition to the above mentioned issues, malaria raises some ethical issues too. For instance, the vector control measures initiated by WHO and governments have been widely criticised for their giving exceeding emphasis on the use of deadly pesticides like DDT. The question is that if mosquitoes should be fought such a way causing more destructive effects on the entire living organisms and environment. Another issue lies with the termination of pregnancy in case of embryonic disability that is caused by malaria when transmitted from mother to its child. Economic impacts of malaria Malaria causes far reaching adverse effects on the economic growth of a country. The World Health Organization reports that high malaria disease rates in countries may reduce its gross domestic product to an extent of 1.3% (Malaria: Issues and Challenges, 2007). Malaria as an epidemic forces governments to spend more on healthcare, which in turn would impede the economic sustainability of the country because this increased spending in public sector adversely affects the economy’s capital accumulation process. This increased spending in healthcare sector aims at developing standard drugs, improved prevention techniques, and co-ordination in operation. African countries are the best example for such economic backwardness where malaria is highly endemic. It is estimated that 1%-5% sub Saharan Africa’s gross domestic product constitutes the direct and indirect costs of malaria, which means US $12 billion annually (Biovision). The effects of malaria may compel employees to halt their works for a long period which would impede the economic growth of the country. In other words, the increase in mortality rate will ultimately reduce the productivity of the country. “Malaria is a disease of poverty and its poor control is retarding development” (WHO). Deaths and malaria related deaths (Source: World Health Report, 2002.WHO) The above diagram is prepared on the basis of World Health Report published by WHO. The graph reflects total malaria related deaths in specific regions in 2002. From the diagram, it is obvious that more deaths (14,467) happened in Southeast Asia in 2002. Out of the total 14,467 deaths, 95 can be attributed to malaria; and it indicates that only 0.7% malaria related deaths occurred in Southeast Asia in 2002. In the case of Western Pacific, the total number of deaths was 11,636 out of which malaria related deaths represented only 10. This figure is negligible while comparing with total deaths of the country during the period. Similarly, deaths in Europe in the year 2002 were 9703. However, it is interesting to note that no malaria related death occurred in Europe during 2002. At the same time, total deaths in America were 5911 in 2002, out of which only one was due to malaria. On the other hand, Africa’s total deaths in 2002 were 10,681 but 963 of these deaths were related to catastrophic complication of malaria. In addition, this figure (963) constitutes 9% of the total deaths. Here, we should consider the fact that Europe and America are two economically developed regions, whereas Africa is an underdeveloped region. The data of Europe, America, and Africa support the idea that ‘malaria is the disease of poverty’. Diagnosis of malaria Microscopic examination of blood is the main technique to diagnose malaria. In addition, saliva and urine are also tested to verify the accuracy of the malaria diagnosis. Some of those methods are described below; 1. Blood films This microscopic examination is the most commonly used method as it assists physician to verify the presence of four major parasite species which are of distinctive characteristics. Two sorts of blood films such as thin films and thick films are the major techniques used in this method. 2. Antigen tests Immunochromatograhic test, also called malaria rapid diagnostic test is a simple test done on a single drop of blood (The medical news). This test takes only 15-20 minutes. The most attractive feature of these types of tests is the visually presented results so that it enables easy diagnosis. However, it will only help detecting parasites in blood and does not give any information regarding their intensity. 3. Molecular methods Molecular tests are more accurate than microscopic tests. These types of tests are mainly deployed in endemic areas but require improved laboratory facilities and higher costs. Suggestions for mitigation Since mosquitoes are the major transmitters of malaria, the prevention strategies begin with mosquito annihilation. Similarly, effective drugs including prophylactic drugs are distributed in malaria endemic areas. High population density is one of the major causes of the continued prevalence of malaria. The experience of many countries reveals that prevention of malaria will be more cost-effective than its treatment. In the opinion of Sachs, Teklehaimanot, and Curtis (as cited in Medical news today, 2007), Africa can achieve effective malaria control at the minimal cost of $3 billion per year if it is utilised in a systematic manner. While formulating malaria prevention methods, it is necessary to consider various features of the country such as population, demographics, and culture. Some most effective and popular prevention methods are medications, vector control, and vaccinations. For the malarial medication purpose, a variety of drugs such as mefloquine and doxycycline have been developed (Kakkilaya, 2008). However, drug selection must be made after a careful examination of parasites’ characteristics of the particular area. Similarly, vector control is the most important step which would cut the roots of the disease from the region. However, effective vector control requires collaborated efforts of public authorities, social organizations, and general public. A well designed sanitation process would effectively prevent the reproduction and spread of mosquitoes. Malaria was eliminated from US in the early 20th century by the application of sanitation techniques although it heavily relied on the use of DDT. Although many countries have developed varieties of vaccines, none of them are cent percent effective in preventing malaria. Conclusion Malaria is highly endemic in underdeveloped regions like African countries. It is potential to raise disastrous complications if not treated right time. Some forms of malaria, namely cerebral malaria are highly fatal in nature. The disease and associated problems cause far reaching consequences on the nations’ economy. The data collected show that malaria is more disastrous in underdeveloped regions than developed countries. As a societal issue, it raises some ethical problems also with regard to embryonic disability and abortion. Effective prevention techniques including medication, vector control, and vaccination would mitigate the impacts of malaria to a large extent. Reference Cotter, S. M. (2001). Hematology. USA: Teton New Media. Ichhpujani, R. L & Bhatia, R. (2002). Medical Parasitology. New Delhi: Jaypee Brothers Publishers. “Jeffrey Sachs calls for mass distribution of insecticidal bednets to fight malaria”. (2007). Medical News Today. Retrieved 4 March 2011 from http://www.medicalnewstoday.com/articles/74907.php Kakkilaya, B. S. (2008). Chemoprophylaxis for malaria. Malaria Site: All about malaria. Retrieved 4 March 2011 from http://www.malariasite.com/malaria/Prophylaxis.htm Malaria diagnosis. (n. d). The Medical News. Retrievied 4 march 2011 from http://www.news-medical.net/health/Malaria-Diagnosis.aspx Malaria. (2010). World Health Organization. Retrieved 4 March 2011 from http://www.who.int/mediacentre/factsheets/fs094/en/ Malaria: Issues and challenges. (2007). World Health Organization: Regional office for South-East Asia. Retrieved 4 March 2011 from http://www.searo.who.int/en/Section10/Section21/Section336.htm Rietveld, A. E. C & Schlagenhauf, L.P. (2008). Special Groups: Pregnant women, infants and young children, Travelers’ malaria. USA: BC Decker Inc. Researchers link cerebral malaria to epilepsy, behavior disorders. (2010). Physorg.com. Retrieved 4 March 2011 from http://www.physorg.com/news/2010-11-link-cerebral-malaria-epilepsy-behavior.html World health report. (2002). World Health Organization. Retrieved 4 March 2011 from http://www.ncbi.nlm.nih.gov/books/NBK3750/table/A40/?report=objectonly World Health Organization. (2005). Malaria control in complex emergencies: An inter- agency field handbook. Switzerland: World Health Organization. Read More