According to the WHO, 3.3 billion people, half the world'spopulation is at risk of malaria. There were 247 million estimated cases ofmalaria in 2006. Of these cases, over 43% were in just five African countries,Kenya being one of them.
Malaria is the leading cause of morbidity and mortality inKenya; the most vulnerable groups are pregnant women and children under 5. Upto 25 million Kenyans (70% of the population) are at risk of malaria infection. The malaria epidemic is highest during the long and shortrainy seasons, around April and October; malaria transmission, however, occurs yearround. Malaria has been endemic in Kenya's swampy lowlands and at the humidcoast; in recent years, due to climate changes that have brought about warmertemperatures, there has been an increase in cases in Kenya's highland regions --once deemed too cool for both parasite and mosquito development and survival. As the World Malaria day wascommemorated on the 25th of April, 2009, the Rollback MalariaPartnership cites several challenges faced in fighting this disease in Kenya. Thechallenges include poor documentation at all levels of prevention and treatmentas well as the dependency on funding from donors, which leads to the questionof sustainability of control methods.  The aforementioned climate changes are certainly increasingthe disease burden in the country, so more widespread and efficientvector control efforts and drug interventions to treat infected people are necessary. Thereare several vector control methods in place, such as distribution of insecticide-treatedbed nets and indoor spraying of insecticides. Ineffective implementation ofthese methods, such as infrequent net use, results in an increase in malariainfections. A recent article in the DailyNation reported a new trend in Nyanza province: people were allegedlyturning bed nets into fishing gear and wedding dresses. These vector controlstrategies will certainly be more effective if the government providesinsecticide-treated nets at a subsidized cost or free in high-risk areas.Increased education of the proper use and importance of sleeping under a bednet is also vital. According to the Kenya Ministry of Health's Division of Malaria Control, thegovernment's strategy to control malaria includes ensuring use of insecticide-treatednets by at-risk communities, carrying out more widespread preventive measuressuch as the Indoor Residue Spraying (IRS) campaigns, and arming the public withmore information about Malaria prevention and treatment. The government alsoaims to improve epidemic preparedness and response by establishing early malariawarning and detection systems. Given the ongoing debate among scientists andthe Division of Malaria Control regarding the onset of insecticide-resistant mosquitoes,these early detection and monitoring systems will have to be strengthened inorder to ensure the use of the most efficient vector control strategies. Background: Parasite Life Cycle Malaria is caused by the parasites of the species Plasmodium. Plasmodium falciparum and Plasmodium vivax are the most commonspecies, with P. falciparum being themost deadly. The parasites infect the Anopheles mosquito. 
| | Malaria Life Cycle | 1. When an infected mosquitopenetrates human skin, it injects saliva mixed with an anticoagulant. It willalso inject elongated Plasmodium sporozoites (motile, spindle-shapedasexual cells) into the human's bloodstream. The sporozoites travel to the liverwhere they rapidly divide asexually, generating the next life cycle form, merozoites. 2. The merozoites are releasedfrom the liver cells and enter the blood stream, where they invade erythrocytes(red blood cells), where they enlarge and divide asexually to produce polynucleatedforms called schizonts. 3. The schizonts then divide andproduce mononucleated merozoites. Some erythrocytes rupture,releasing these toxic merozoites throughout the body of the host, causing thewell-known cycle of fever and chills that is characteristic of malaria. 4. Some merozoites in theerythrocytes undergo sexual reproduction, forming gametocytes. Erythrocytes containing gametocytes do not rapture. 5. Gametocytes are incapable ofproducing gametes within their human hosts, and do so only when they areextracted from the infected human host by a mosquito. 6. The gametocytes form male and female gametes within themosquito's gut. These gametes then produce diploid zygotes. 7. These diploid zygotes thendevelop and differentiate into oocyteswithin the mosquito's intestinal walls. Within the oocytes, repeatedmitotic divisions take place, producing large numbers of sporozoites. 8. These sporozoites then migrateto the mosquito's salivary glands, and are then injected into the humanbloodstream, thus starting the parasite life cycle again. Symptoms
Fever, headache, chills and vomiting - these symptoms typically appear10-15days following infection. If not treated promptly, the symptoms can getmore severe, from cerebral complications to lung and kidney failures. Treatment: Two important currently used antimalarial drugs are derivedfrom plants whose medicinal values had been noted for centuries: artemisinin from the Qinghao plant (Artemisiaannua L, China, 4thcentury) and quinine from thecinchona tree (South America, 17th century). Currently, artemisinin-based combination therapies (ACTs)are being used, particularly for P.falciparum malaria. Due to potential drug resistance by the parasite, WHOrecommends using artemisinins in combination as ACTs, as this combination pillis more effective than the use of just one artemisinin drug. Continuous drugmonitoring is highly essential to prevent the spread of drug resistantparasites. Prevention: Prevention focuses on vector control methods, whichinclude: 1) Use of insecticide-treated bed nets and curtains. If they are properlyapplied, they can provide a 30-60% reduction in Malaria morbidity. Across Africa, there has been an increase in the distribution ofnewer, long-lasting insecticide-treated nets that are effective for threeyears. 2) Indoor spraying of insecticides,especially in high-mortality endemic areas and in drug-resistant areas.Challenges include sustainability and cost-effectiveness. 3) Larval control, given that the mosquitovectors tend to breed everywhere in a small amount of water on the ground.Larval control can be attained through environmental management, large spacecoverage, and community participation, and both chemical and biological methodscan be employed. 4) Environmental control to preventbreeding, nesting and feeding of mosquito vectors by breeding site reduction.Some of the factors that increase these breeding sites include road, dam orpipeline construction, deforestation, and irrigation.
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