SHAWWAL 5, 1429 A.H.
FRIDAY OCTOBER 3 2008
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Malaria the silent killer
By Anjuguri Jesse Manzah
In a relationship, the long standing norm has been that the relationship favours both parties equally. The symbiotic nature of such relationship makes it a long lasting one because of its intrinsic fairness. On the contrary, the relationship between man and mosquito is a violation of this norm. It is a non symbiotic relationship that favours a party at the detriment of the other. In this case, mosquito benefit while man is left with his fate to contend with. While many are bedridden as a result of this infection, others end up lifeless.
The aftermath of this age long relationship is malaria. This infection has constituted a great threat to human lives, especially among Africans and some third world countries. For decades these countries have had to contend with this infection to no avail.
“500 million cases of malaria each year, and up to 1.5 million deaths. The majority in sub-Saharan Africa, which is home to an estimated 80 % of the world’s malaria cases”, said Africa Medical and Research Foundation (AMREF) in its 2008 report.
While human beings feed on grains, fruits, meat and other food supplements to survive, mosquitoes make their living from sucking human blood. This has given impetus to the widespread of malaria infection among human beings. In exchange for the blood mosquitoes suck from their preys, they live behind the malaria infection.
“Malaria is an infectious disease caused by a celled parasite known as plasmodium. The parasite is transmitted to humans by the bite of the female Anopheles mosquito. The plasmodium parasite spends it lifecycle partly in humans and partly in mosquitoes.
“Mosquito infected with malaria parasite bites humans passing cells called sporozoites travel to the liver. Each sporozoite undergoes asexual reproduction, in which its nucleus spites to form two new cells, called merozoites,” said John H. Adams
In addition, he said “merozoites enter the bloodstream and infect red blood cells. In the red blood cells merozoites grow and divide to produce more merozoites eventually causing the red blood cells to rupture.”
Until 19th century, the exact cause of this infection was not known. It had it sway for centuries among humans without any knowledge of the vector behind it. However, it was cause was brought to lime light through the relentless effort of some concerned individuals.
“In 1880 the French surgeon Charles Alphonse Laveran identified malaria parasite in the blood of a patient. In 1899 Sir Ronald Ross, a British physician, demonstrated that the parasite is transmitted from human to human by the female Anopheles mosquito,” said john Adams.
Nigeria’s inclusion in the list of countries with the highest concentration of this infection is irrefutable. The country’s poor environmental state speaks for itself. It vulnerability is better explained by a walk through its dirt stricken streets which are homes to mosquitoes.
Rampant on the streets and next to many homes are stagnant bodies of water littered with mosquito larvae floating freely on them. This has increased the number of mosquitoes in the country. Mosquitoes take advantage of such sites to breed. Ironically, most Nigerians harbour these sites and their inhabitants (mosquitoes) as tourist attractions. They prove ignorant of its implication on human health.
Sadly, while people like Abubakar, a motorcyclist, say he is not aware of the existence of mosquito larvae in these stagnant bodies of water, others the well informed individuals have done nothing to curb it.
Living next to these sites are practicing medical doctors, health workers, journalists, teachers, lectures, religious leaders, students and a host of well informed citizens who are contributing in breeding more mosquitoes for the spread of malaria in Nigeria.
“Malaria in humans is caused by four species of plasmodium parasites. Plasmodium falciparun is the most common specieas in tropical areas and is transmitted primary during rainy season. This species is the most dangerous, accounting for half of all clinical cases of malaria and 90 per cent of deaths from the disease. Plasmodium vivax is the most widely distributed parasite, existing in temperate and tropical climates but is less common than plasmodium vivax. Plasmodium ovale is a relatively rare parasite restricted to tropical climates and found primarily in eastern Africa,” said John H. Adams.
The proneness of people to malaria cuts across board. Nonetheless, certain groups of people are more vulnerable than others.
“In Africa, children under five years and pregnant women bear the brunt of the disease because of lower or underdeveloped immunity,” said AMREF.
Additionally, “most of the deaths and severe illnesses caused by malaria occur in infants, children and pregnant women. Infants and children are vulnerable because they have had fewer infections and have not yet built up immunity to the parasite. Pregnant women are more susceptible to malaria because the immune system is somewhat suppressed during pregnancy.
“The malaria parasite uses a specific molecule to attach to the tiny blood vessels of the placenta, the tissue that nourishes the fetus and links it to the mother. This phenomenon makes a woman particularly vulnerable to malaria during pregnancy,” said John H. Adams.
Malaria infection has place the future of our country under serious threat. It is the leading cause of death today in Nigeria and Africa at large. “Each year than 300 million cases of malaria are diagnosed, and more than 1.5 million die of the disease,” said WHO.
In a related development, AMREF said “malaria is the leading cause of death for fewer than fives in Africa-killing 1.1 million every year. Children that survive may suffer anaemia and celebral problems that affect long term development”.
Roaming the Nigerian streets are people who carry the malaria infection in them. Regrettably, most of these individuals are ignorant of the symptoms of this infection. They mistook its symptoms to headache, cold or even witchcraft. Ignorantly, they source for cure through diabolic means without attending to the malaria infection. This has also given impetus to large number of deaths recorded as a result of this deathly infection.
“The fever that characterise malaria develops when merozoites invade and destroy red blood cells. The destruction of the red blood cells spills wastes, toxins, and other debris into the blood. The body responds by producing fever, an immune response that speeds up other immune defenses to fight the foreign invaders in the blood. The fever usually occurs in intermittent episodes.
“An episode begins with sudden, violent chills, soon followed by an intense fever and then profuse sweating that brings the patient’s temperature down again. Upon initial infection with the malaria parasite, the episodes of fever frequently last 12 hours and usually leave an individual exhausted and bedridden. Repeated infection with the malaria parasite can lead to severe anaemia, a decrease in the concentration of red blood cells in the blood system. The malaria parasite consumes or renders unusable the protein and other vital components of the patient’s red cells.
“The pattern of intermittent fever and other symptoms in malaria varies depending on which species of plasmodium is responsible for the infection. Infections caused by plasmodium falciparum, plasmodium vivax, and plasmodium ovale typically produce fever approximately every 48 hours, o every first and third day. Infections caused by plasmodium malariae produce fever every 72 hours, or every fourth day,” said John H. Adams.
Furthermore, he said “infections caused by plasmodium falciparum are marked by their severity and high fatality rate. This type of malaria can also cause severe headaches, convulsions, and delirium. The infection sometimes develops into cerebral malaria, in which red blood cells infected with parasites attach to tiny blood vessels in the brain, causing inflammation and blocking the flow of blood and oxygen. In plasmodium vinax and plasmodium ovale, infections, some merozoites can remain dormant in the liver for three month to five years. These merozoites periodically enter the bloodstream, triggering malaria relapses”.
Decades after the discovery of the vector behind the spread of malaria infection, the developed world has successfully walked its way out of it. Unfortunately, Nigeria is still battling with it.
The onus of fighting this deadly infection lies with both the Nigeria government and its citizens. They play their role effectively at their various levels for a successful result. Their hands must be on deck if any meaningful success would be attained. In other word, words and action should be inseparable companions for a victorious fight against malaria in the country.
Victory over malaria will sum up to wishful thinking if the proliferation of stagnant bodies of water is left unaddressed. The centrality of such sites to the survival of mosquitoes cannot be over emphasised. They are breeding sites for mosquitoes.They serve as incubation sites for eggs laid by mosquitoes. The presence of these sites render ineffective the effort to curb the spread of malaria. Therefore, the destruction of such sites will be appropriate for the elimination of malaria.
To curtail the proliferation of breeding sites for mosquitoes, drainages and gutters must be in perfect condition at all times. Its implementation portends that mosquitoes will be deprive of their breeding sites. A further step at disinfecting such sites will not only be helpful but paramount in eliminating mosquitoes.
“Permanently destroying bodies of stagnant water where mosquitoes lay their eggs; treating such habitants with insecticides to kill mosquito larvae; fogging or spraying insecticides to kill adult mosquitoes; or using mosquito netting or protective clothing to prevent contact with mosquitoes,” said John H. Adams.
Furthermore, massive campaign should be carried out to sensitise and educate Nigerians about malaria. Its ca uses, signs and symptom, and prevention. The significance of this campaign cannot be over stressed as most Nigerians are ignorant of this infection.
The only case Nigerians have against mosquitoes is that it interrupts their sleep. Nonetheless, the effort of the government in religiously carrying out the sensitisation exercise will be a drastic measure in arming ignorant Nigerians with information about malaria.
The fact that government has been playing an active role in combating malaria is not disputable. However, much still needs to be done to avoid the further lost lives to this deadly infection. Health facilities should be brought close to the people. This will helping times of emergency.
Additionally, the distribution of treated mosquito nets should not be politicised. They should be equitably distributed irrespective of tribal or religious sentiment especially to women and children who are the most vulnerable group.
The mentality of waiting for the whites to come and fight malaria on our behalf should be discarded. Nigerian leaders should know that the whites are not susceptible to malaria. So it does not affect them if we live or die of malaria infection. Instead of waiting for assistance from the whites which has not yielded any meaningful result, Nigerians most rise to the occasion and the bull by the horn. Our messiah is not from without; it is from the length and breadth of this country.
The nonchalant attitude that is greeting the production of vaccine for malaria should be a cautionary and wake-up call to Nigerians. The absence of this infection in the western world is prominent among the factors militating against the production of vaccine for it. Nigerian leaders must be willing to pay the prize if they really mean well for the country’s citizens.
The treatment and prevention of malaria is known to be cost effective. However, the Nigerian government must do all within its reach to help in the total eradication malaria out of the country. All funds earmarked for project that do not have direct impact on the people should be channeled toward this cause.
The so-called monies for constituency projects that are hijacked in the bank accounts of senators distinguish members of the House of Representatives and State Assemblies should be invested in the fight against malaria.
This could serve as a good campaign strategy for those of them nursing the ambition of reelection or political appointment.
Politicians should note that the death and the sick cannot participate in voting them. This is a passionate call to all well meaning Nigerians to their quota in eradicating malaria out of our country.
Anjuguri Jesse Manzah is a corps member serving with triumph. He can be reached through his e-mail: jesse0183@yahoo.com
