Malaria

According to World Health Organization estimates, malaria killed 660,000 people in 2010 and infected 216 million. Ninety per cent of deaths were in Africa.

Despite malaria mortality rates falling by 25 per cent since 2000, a child in Africa still dies every minute from malaria.

Malaria is most common in poor, under-resourced areas. In many cases, malaria itself contributes to poverty: bedridden patients create burdens on households and health services, leading to huge income losses in malaria-endemic countries. This suffering and loss of life are unnecessary, because malaria is largely preventable, detectable and treatable.

While ninety per cent of malaria deaths occur in sub-Saharan Africa, the disease is present in nearly every tropical area where MSF works: from Ethiopia and Sierra Leone to Cambodia and Myanmar.

What causes malaria?

Malaria is a parasitic infection transmitted from person to person by the bite of infected female Anopheles mosquitoes. These mosquitoes usually bite from dusk to dawn.

Once transferred to the human body, the infection travels to the liver where it multiplies and then enters the red blood cells. Inside the red blood cells the parasites multiply rapidly until they burst through the cell walls, releasing even more parasites into the blood stream.

There are four main species of the malaria parasite: Plasmodium falciparum, Plasmodium malariae, Plasmodium vivax and Plasmodium ovale. P. falciparum is the main cause of severe malaria and death.

Symptoms of malaria

Malaria begins as a flu-like illness, with symptoms first occurring nine to 14 days after infection. Symptoms include fever (cycles of fever, chills and sweating may develop), joint pain, headaches, vomiting and convulsions. Coma may ensue.

If simple malaria is left untreated, it can become severe — around eight million malaria cases progress to severe malaria annually. Death from malaria may be due to brain damage (cerebral malaria), or damage to vital organs. The reduction of red blood cells can cause anemia.

Diagnosing malaria

Diagnosing malaria is done with rapid dipstick tests or by looking for the parasite under a microscope in a blood smear. However, rapid tests are not always available, and microscopy is not always straightforward. As a result, diagnosis based on symptoms is still normal in much of the developing world.

This means patients are often misdiagnosed and the real reasons for their symptoms go untreated. It also means that anti-malarial drugs are overused and go to waste when they are desperately needed.

Treating malaria

The most effective treatment for malaria is artemisinin-based combination therapy (ACTs). ACTs have low toxicity, few side effects and act rapidly against the parasite.

Today, 41 out of 54 African countries have protocols that recommend ACTs as a first-line treatment for malaria. But in many places where MSF works, ACTs are scarce. The global need for ACTs is estimated to be at 300 to 500 million treatment courses per year, however, in 2006, drugs for less than 90 million treatments were purchased.

A three-day course of anti-malarial pills for a baby can cost as little as 40 cents.

Long lasting insecticide-treated bed nets are an important means of controlling malaria. In endemic areas, MSF distributes nets to pregnant women and children under the age of five, who are most vulnerable to severe malaria.

In 2012, MSF treated 1,642,800 malaria cases.

Check out the interactive guide to malaria: