Introduction

Malaria is a mosquito borne disease caused by parasite. Female Anopheles mosquitoes are the vector that transmits malaria. Among many species P.vivax and P.falciparum are the one that infect human the most.

Global Situation

There are many places which have eliminated malaria but still about 3.2 billion people live in malaria prone area in about 106 countries and territories. According to WHO, in 2015 malaria caused 212 million clinical cases and 429,000 deaths.

Signs and Symptoms

In a non-immune individual, symptoms usually appear 10-15 days after the infected mosquito bites.
The first symptoms are fever, headache, and chills but they may be mild and difficult to recognize as Malaria. As it is as normal fever.
In malaria, there are mainly three stages; 1^st is shivering, cold stage for about 15-60 minutes. 2^nd stage is hot stage where patient has fever about 41 C, dry skin, headache, nausea and vomiting, this is about 2-6 hrs, the last stage is sweating stage, in this stage fever stops and patient sweats a lot.
In children: severe anemia, respiratory distress in relation to metabolic acidosis, or cerebral malaria.
In adults: multi organ involvement is frequent.

Pathogenesis

The fever and chills are associated with the rupture of erythrocytic-stage schizonts. This rupture triggers a host immune response. The cytokines and other cellular products released during the immune response are responsible for the fever, chills, sweats, weakness and other symptoms.
In malaria caused by falciparum; at severe stage, local hypoxia and the release of toxic cellular products may occur.
In extreme severe condition there is obstruction of the microcirculation in the brain and other vital organs.

Epidemiology

Malaria is transmitted by the bite of infected Anopheles mosquito. This mosquito mostly bites at night and mostly is found in rural parts. Malaria is widely transmitted in all over the world despite of tropics and subtropics regions. In US and Europe Malaria has been eliminated. The endemic transmission of malaria is seasonal.

Prevention

Malaria is curable and preventable but the measures must be taken at right time.Vector control is the major step to be taken to reduce malaria transmission.

Some of the major vector control methods are given:

Indoor spraying with residual insecticides

Indoor residual Spraying can be used to reduce malarial infection. This can last long up to 3-6months regarding the insecticide used, types of surface on which it is sprayed.

Long lasting insecticidal nets (LLINs):

They are preferred in public health program. In the malaria prone areas this intervention is the best, and is recommended by WHO. It is cheap and effective.

Antimalarial drugs.

Not only to cure, drugs can also be used to prevent. Malaria can be prevented through chemoprophylaxis; travellers can take these drugs while going to malaria prone areas.

Outdoor spraying:

Domestic animals shelters are also shelters for mosquitoes. Hence spraying can be done there. Outdoor spraying can do well at the time of epidemics of malaria and other vector borne diseases.

Applying insect repellents

Coils, aerosols also are effective for killing and repelling mosquitoes.

Breeding habitats must be reduced or destroyed. Stagnant water are also the breeding places for mosquitoes so they should be cleared away. Water- storage containers can be designed to prevent access by mosquitoes for laying eggs.
Biological control methods can also be used Larvivorous fishes and copepods are effective in controlling the larva of mosquitoes.
Waste managements is also the major preventing methods of most of all diseases.

Treatment

Malaria is fatal disease. Treatment should be started as soon as possible. Early screening and diagnosis is necessary. Treatment of the malaria depends upon the parasite that infects. There are many drugs given to malaria patients, some of them are: Chloroquine, Atovaquone-proguanil, Artemether-lumefantrine, Mefloquine, Quinine, Quinidine, Doxycycline, Clindamycin, Artesunate.

References