THINK OF THESE: End of malaria

We often read bad news.  But there’s a good news recently.  In a press release by the state-owned Philippine News Agency, we learned that the entire South Cotabato province is now free from malaria.

“We had zero case of locally-transmitted malaria in the last five years so we’re now considered malaria-free,” Jose Barroquillo, malaria program coordinator of the Integrated Provincial Health Office was quoted as saying.

The Department of Health said that a province may be declared as malaria-free if it sustains zero incidence of indigenous case of the disease for five consecutive years.  The health department declared such province along with the World Health Organization (WHO), a United Nations agency which has been supporting the national government’s malaria eradication program.

South Cotabato has joined a roster of provinces which has been declared malaria-free.   Among those listed before were Aklan, Albay, Batangas, Batanes, Biliran, Benguet, Bohol, Camarines Sur, Camiguin, Capiz, Catanduanes, Cavite, Cebu, Dinagat Islands, Eastern Samar, Guimaras, Marinduque, Northern Leyte, Northern Samar, Southern Leyte, Sorsogon, Surigao del Norte, and Western Samar.

Davao City and the four provinces of Davao Region – Davao del Sur, Davao del Norte, Davao Occidental and Compostela Valley – are still to join the magic list.  Only Davao Oriental has been declared as malaria-free in 2015.

The Infectious Disease Office (IDO) of the health department is in-charge of training local officials, providing essential commodities vector and disease control, and helping the community deal with the infectious diseases.

Concerning malaria, the IDO develops policies, rules, regulations, and guidelines to keep the illness at bay.  In addition, it constantly looks for advocacy activities to reach as many people as it can.

But like most health programs, it is easier said than done.  Take the case of providing services to people.  It has been reported that some IDO staff find it hard to reach certain people “because they’re very mobile,” or always on the move.  There are also people who are hard to be reached like those living in forested areas.

Another challenge in the fight against malaria is the disease’s asymptomatic cases.  “A person might be a carrier of the disease but he shows no signs and symptoms,” a health official explained.  “Thus, that person can go to other places and there, (he unknowingly) spreads the disease.”

So, is there no possibility that the disease will not come back to those places declared malaria-free already?  That’s the biggest challenge IDO faces – “how to sustain the malaria-free areas and for the incidence not to come back.”

“Malaria is by far the world’s most important tropical parasitic disease, and kills more people than any other communicable disease except tuberculosis,” the Geneva-based WHO deplores.  “In many developing countries, malaria exacts an enormous toll in lives, in medical costs, and in days of labor cost.”

Worldwide prevalence of the disease is estimated between 300 million to 500 million cases each year.  Annual death caused by the disease is estimated to be in the range of 1.5 million to 2.7 million.  Every 12 seconds, one dies of malaria somewhere in the world.  “Malaria kills in one year what AIDS killed in 15 years,” the United Nations health agency declares.  “In 15 years, if five million have died of AIDS, 50 million have died of malaria.”

Generally, malaria is spread by the bite of an infected female mosquito.  “Very rarely, the disease is transmitted through a transfusion of contaminated blood or an injection with a needle that was previously used by a person with malaria,” says The Merck Manual of Medical Information.

“The cycle of malarial infection begins when a female mosquito bites a person with malaria,” the Merck manual says.  “The mosquito ingests blood that contains malarial parasites.  Once inside the mosquito, the parasite multiplies and migrates to the mosquito’s salivary gland.

“When the mosquito bites another person, the parasites are injected along with the mosquito’s saliva.  Inside the person, the parasites move to the liver and multiply again,” the manual continues.  “They typically mature over an average of 1-3 weeks, then leave the liver and invade the person’s red blood cells.  The parasites multiply yet again inside the red blood cells, eventually causing the infected cells to rupture.”

There are four species of malaria parasites that can infect people: Plasmodium falciparum, Plasmodium vivax, Plasmodium ovale and Plasmodium malariae.  “Plasmodium vivax and Plasmodium ovale can remain in the liver in a dormant form that periodically releases mature parasites into the bloodstream, causing recurring attacks of symptoms,” the Merck manual says.

Today, “malaria is the world’s leading killer among infectious diseases in tropical Africa, Southeast Asia, parts of India, southern China, Latin America, Haiti and some Pacific Islands,” writes journalist Anne T. Merriman, who suffered malaria while visiting Tanzania some years back.

“In spite of drug resistance, malaria is a curable disease, not an inevitable burden,” assures the WHO.  “Although there are only a limited number of drugs, if these are used properly and targeted to those at greatest risk, malaria disease and deaths can be reduced, as has been shown in many countries.”

A professor of medicine in one of the country’s leading universities visited a colleague working in the hinterlands of Palawan.  He stayed for at least two weeks.  On the plane coming home, he developed shaking chills and a high fever, which he assumed were caused by either a urinary or respiratory tract infection.  Malaria was the further thing from his mind.

A few hours, the fever and shakes suddenly disappeared – without any treatment!  He was puzzled by this strange attack, and dismissed it as probably due to some unusual virus.  A couple of days later, while lecturing at a meeting in Pasay City, he suddenly developed another paroxysm of shaking chills and fever.  It was so severe that he was unable to continue his presentation.  A close friend who happened to be around made the right diagnosis of malaria, which was confirmed by a blood test.  He was successfully treated and has had no recurrence since.

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