Thursday, February 18, 2016

Malaria - the harsh realities

More than you ever wanted to know about malaria:

In Honduras, we know that malaria is a reality, but the actual prevalence was small enough that we didn't really think twice about it.  Going to a new country, we knew that we were going to have to do some research, talk to doctors, and talk to our team mates on the ground to better understand what our new reality is going to be.

A little background - in the 8 years we were in Honduras, not a single person on our team contracted malaria, and given that none of us take medication for malaria prevention, that's saying something.  I never treated anyone at my clinic with malaria.  Again - we know it's a reality, but it's just not that high up on our radar.

Now we are facing a new reality.  To give some comparisons - I've done some research using WHO's (World Health Organization) data - they are the go-to for endemic, epidemic and pandemic problems around the world.  In Honduras, there is a population of 7,960,000.  For the entire country, in 2013, there were 15,000 estimated cases of malaria with less than 10 deaths (1)- so 0.2 % of the population has malaria.  In  contrast, Equatorial Guinea has a population of  821,000.  There were 290,000 cases of malaria, with 440 deaths (2).  That means that 35% of the population in Equatorial Guinea had malaria in 2013.  Malaria is the number 4 cause of death in Equatorial Guinea.

There are many types of malaria, but there are two (primary) types of malaria. The first, and less virulent malaria is caused by P. Vivax.  The second, and leading cause of death, is caused by P. falciparum. P. Vivax is what the majority of malaria cases are in Honduras, and, you guessed it - 100% of the cases in Equatorial Guinea are from P. falciparum.

Around the world, malaria is the most significant parasitic disease of humans, and claims the lives of more children worldwide than any other infectious disease.  In 2015, there were 214 million cases of malaria worldwide. This resulted in an estimated 438,000 deaths, 90% of which occurred in Africa. Severe malaria is usually caused by P. falciparum . Symptoms of falciparum malaria arise 9–30 days after infection. Individuals with cerebral malaria frequently exhibit neurological symptoms including seizures, coma and death. 

The malaria in Honduras is not resistant to chloroquine, the malaria in Equatorial guinea is - so we have to take medications specifically for this type of malaria.

OUR Bottom line - we are using bug spray, all our clothing will be treated with permethrin, we will sleep under mosquito nets treated with permethrin, and taking anti-malaria medication.

YOUR bottom line - COME VISIT - but come prepared!  Talk to your physician about which medication to take, treat all your clothing with permethrin, and use bug spray.