Dealing with Malaria during Covid-19 Pandemic

Overview

The World Health Organization (WHO) defines Malaria as a life-threatening disease caused by parasites that are transmitted to people through the bites of infected female Anopheles mosquitoes. As the entire world is dealing with the effects of the COVID-19 pandemic, there is an urgent need to ensure that severe diseases like Malaria aren’t neglected.

In 2019, there was an estimate of 229 million malaria cases worldwide. India represents 3% of the global malaria burden but has shown a remarkable decline in malarial incidence over the years. India has a vision of becoming a malaria-free country by 2027 and hopes to eliminate it by 2030.

Some population groups like infants, children under the age of 5, pregnant women, patients with AIDS/HIV, and frequent travelers are at a considerably higher risk. Transmission is higher in places where mosquitoes thrive.

Symptoms of Malaria

Unlike COVID-19, where symptoms appear 2-14 days after exposure, symptoms of malaria in a non-immune individual usually appear 10-15 days after the infective mosquito bite. These can include:

1. Fever
2. Headache
3. Muscle pain
4. Vomiting
5. Chills

These symptoms are often mild and sometimes difficult to recognize in relation to malaria.

If you experience any of the symptoms, medical consultation is strongly recommended. This is because not only is diagnosing Malaria early very crucial, but also necessary to eliminate the possibility of a COVID-19 infection.

Malaria in the Current Scenario

Experience from previous disease outbreaks, for example in the case of the 2014-2016 Ebola virus epidemic, has shown that a disruptive effect in the delivery of health services invariably leads to a massive increase in malaria-related illnesses.

A similar scenario is to be foreseen in the current Covid -19 global pandemic. The WHO has already reported more than 1 million confirmed cases of Malaria since the beginning of COVID-19 pandemic. Some cases of dual infections of COVID-19 and Malaria have been detected; this is extremely worrisome and it may double the harmful implications.

Moreover, lockdowns in most parts of the world have led to the delays in the delivery of insecticide-treated nets (ITNs) and indoor residual spraying (IRS) activities. Most people were unable or unwilling to visit healthcare facilities due to the fear of being infected with Covid -19.

Therefore, it is very important to minimize the risk of COVID-19 transmission among people and health providers, which may in turn, help restrict the spread of malaria.

Dealing with Malaria during the Pandemic

The WHO strongly recommend countries not to suspend their vector control activities in lieu of the pandemic. Modifications can be made to existing ITN & IRS campaigns to counter the risks of contracting COVID-19. There are also no changes to the diagnosis and treatment of the disease.

In this predicament, there may also be a cause for special measures like presumptive treatment or the mass administering of antimalarial drugs. This is mainly done to lower malaria-related mortality and keep health workers and communities safe. Surveillance should be optimized and real-time data should be collected to accurately assess disease trends and execute programs at the local and district levels.

While almost all civic staff members are now on COVID-19 duty, efforts should still be made for some of them to continue surveillance to detect potential mosquito breeding spots.

An increasing amount of Malaria cases are coming in from India’s remote areas implying an urgent need to increase funding, invest in capacity building, & train local staff to keep populations healthy.

How to prevent the transmission of malaria?

Vector control is the most significant way to reduce and prevent the transmission of malaria. In this method, the birds, mammals, or insects (collectively called vectors) which transmit disease pathogens are limited or eradicated. The two main applicable measures for malaria vector control are as follows:

1. Insecticide-treated (mosquito) nets/ITN: Sleeping under an ITN can help reduce the contact between mosquitoes and humans, while simultaneously providing an insecticidal (capable of killing or limiting their growth) effect.
2. Indoor residual spraying/IRS: This process involves spraying the inside of a house with insecticides, typically once or twice a year.

Conclusion

With the COVID-19 crisis having a major impact on the healthcare system of the country, it is important to take appropriate measures to prevent the spread of life-threatening diseases like Malaria. Its symptoms bear a striking resemblance to those associated with the novel Coronavirus and hence, it is crucial to educate citizens and aim to detect Malaria in its early stages of infection.

Doctors should be aware of the fact that Covid -19  has not replaced all other infectious diseases. We need to fight both these diseases together.

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Frequently Asked Questions (FAQs)

• Is self-treatment for malaria recommended?

Self-treatment of malarial infection can be undertaken if professional medical care is not available within 24 hours. Travelers who self-medicate should contact their doctor to fully understand the best method of treatment in their respective cases.

• Are there any long-term effects of drugs prescribed for malaria?

The drugs used to prevent malaria are known to be safe and are tolerated well in long-term use. Medical guidance is strongly advised.

• Is it considered safe to breastfeed while taking an antimalarial drug?

There is limited data available about the safety of breastfeeding while consuming antimalarial drugs and hence, it is not recommended, especially if the infant weighs less than 5 kgs.

• Can infants and children be given antimalarial drugs?

Infants and children can only be given certain types of antimalarial drugs, as some may not be suitable for them. Additionally, the doses are given depending on the child’s weight.

• Can one donate blood after having contracted malaria?

People diagnosed with malaria cannot donate blood for 3 years after treatment. It is also important that they remain symptom-free during that period.