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This intervention method works anytime, and is not directly intervening in any step of malaria's life cycle

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This intervention method works anytime, and is not directly intervening in any step of malaria's life cycle

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INTERVENTION METHOD: Creation of infrastructure 

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INTERVENTION METHOD: Creation of infrastructure 

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Each year, malaria curbs economic growth in a country by 1.3% (3). Over time, this can add up to lost growth totaling billions. A universal prevention method for malaria is the creation of infrastructure that allows for other intervention methods to be delivered to malaria-afflicted regions. Most of these regions are in less developed areas, meaning that currently, any possible intervention methods that exist cannot be delivered to these regions.

The creation of infrastructure will aid the rollout of other malaria intervention methods, hopefully stopping the spread of malaria.

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(3): Jeffrey D. Sachs. “The Economic Burden of Malaria.” Jeffrey D. Sachs, Jeffrey D. Sachs, 18 June 2020, https://www.jeffsachs.org/journal-articles/24g2tkd479x2rw5xyhalgzkfrfkzmw. 

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(3): Jeffrey D. Sachs. “The Economic Burden of Malaria.” Jeffrey D. Sachs, Jeffrey D. Sachs, 18 June 2020, https://www.jeffsachs.org/journal-articles/24g2tkd479x2rw5xyhalgzkfrfkzmw. 

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Transmission blocking vaccines are still in development and do not exist yet. These vaccines would aim to prevent mosquitos from becoming infected when biting people afflicted with malaria. These vaccines do not stop the progression of malaria in humans, but rather the spread of malaria to its mosquito vector.

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These vaccines are for use at malaria's most destructive stage, the infiltration of the blood. These vaccines target the merozoites in the blood, reducing the amount that can infect more RBCs. Those with blood-stage vaccines will still show symptoms, but they will be significantly better than normal.

This vaccine aims to give the body natural immunity to merozoites, allowing it to fight off plasmodium in the blood.

The vaccine currently provides a short-lived natural immunity to merozoites, which means patients require frequent blood-stage vaccines to keep their immunity. A significant development of this vaccine would be a version that provides patients permanent merozoite immunity, giving them complete malaria immunity.

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INTERVENTION METHOD: Pre-erythrocytic vaccines 

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INTERVENTION METHOD: Pre-erythrocytic vaccines 

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Pre-erythrocytic malaria vaccines are able to stop sporozoites in the blood, or if the sporozoites have already reached the liver, destroy infected liver cells.

These vaccines work by introducing the body to circumsporozoite (CS), the dominant protein on sporozoites. This elicits an immune response from the body and trains it to fight off future CS in the blood or liver.

This intervention method is great because it destroys malaria in one's body before symptoms show.

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Natural selection of SCA in malaria-afflicted regions

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Natural selection of SCA in malaria-afflicted regions

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Since sickle cell anemia (SCA) provides resistance to malaria, places most afflicted by malaria—like Western Africa—will have a higher concentration of SCA traits in their people because of natural selection. Those without SCA have a higher chance of dying from malaria, meaning those with SCA will outlive those with normal hemoglobin, allowing for a more dense SCA population.

This can be seen in the connected chart

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Sickle cell anemia (SCA) provides natural resistance to malaria as someone afflicted with SCA will have irregular hemoglobin which malaria cannot feed off of. This reduces the food supply of malaria, making a person with SCA become resistant to malaria.

A carrier of SCA, meaning someone with only 1 abnormal hemoglobin gene, will have less natural malaria resistance than someone with 2 abnormal hemoglobin genes, someone fully afflicted by SCA

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Sickle cell anemia's relation to Malaria

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Sickle cell anemia's relation to Malaria

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On the left, the chart is depicting where Malaria is present in Africa. On the right, the chart is depicting where and the severity of Sickle cell anemia in Africa.

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Plasmodium knowlesi—can only be spread to humans through macaques

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Plasmodium knowlesi—can only be spread to humans through macaques

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Plasmodium falciparum—can lead to liver and kidney failure, convulsions, and a coma.

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Plasmodium falciparum—can lead to liver and kidney failure, convulsions, and a coma.

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5 types of Plasmodium can infect humans (Stanford Medicine):

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5 types of Plasmodium can infect humans (Stanford Medicine):

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Zoom out to make sure you see all content

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(1) Pishchany G, Skaar EP (2012) Taste for Blood: Hemoglobin as a Nutrient Source for Pathogens. PLOS Pathogens 8(3): e1002535.

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(1) Pishchany G, Skaar EP (2012) Taste for Blood: Hemoglobin as a Nutrient Source for Pathogens. PLOS Pathogens 8(3): e1002535.

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The merozoites feed on the hemoglobin in RBCs, consuming more than half of a RBC's hemoglobin in less than 24 hours (1)

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The merozoites feed on the hemoglobin in RBCs, consuming more than half of a RBC's hemoglobin in less than 24 hours (1)

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Humans start showing symptoms of plasmodium when merozoites reproduce in the RBCs. The average incubation period, from mosquito bite to symptoms, is 7-30 days (CDC)

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Humans start showing symptoms of plasmodium when merozoites reproduce in the RBCs. The average incubation period, from mosquito bite to symptoms, is 7-30 days (CDC)

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The sporozoites travel to the mosquitos salivary glands

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The sporozoites travel to the mosquitos salivary glands

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The zygotes develop into ookinetes, which exit the mosquito gut walls

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The zygotes develop into ookinetes, which exit the mosquito gut walls

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The male and female gametocytes maturation is started by the cooling of the warm human blood

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The male and female gametocytes maturation is started by the cooling of the warm human blood

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The trophozoites can enter a sexual cycle where they produce male and female gametocytes, the germinating cells of plasmodium 

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The trophozoites can enter a sexual cycle where they produce male and female gametocytes, the germinating cells of plasmodium 

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The trophozoites exponentially asexually reproduce merozoites, until the number per RBC is too much, bursting the RBC and introducing the new merozoites into the bloodstream. This allows for the merozoites to attack new RBCs, creating exponential reproductive growth.

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The trophozoites exponentially asexually reproduce merozoites, until the number per RBC is too much, bursting the RBC and introducing the new merozoites into the bloodstream. This allows for the merozoites to attack new RBCs, creating exponential reproductive growth.

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(2) Omorou, R., Bin Sa’id, I., Delves, M. et al. Protocols for Plasmodium gametocyte production in vitro: an integrative review and analysis. Parasites Vectors 15, 451 (2022). https://doi.org/10.1186/s13071-022-05566-3

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(2) Omorou, R., Bin Sa’id, I., Delves, M. et al. Protocols for Plasmodium gametocyte production in vitro: an integrative review and analysis. Parasites Vectors 15, 451 (2022). https://doi.org/10.1186/s13071-022-05566-3

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Next, one of two things can happen for each RBC

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Next, one of two things can happen for each RBC

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The plasmodium sporozoites asexually reproduce through schizogony, a process where larger sporozoites divide into many identical cells called schizonts, which contain anywhere from 8-32 merozoites.

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The plasmodium sporozoites asexually reproduce through schizogony, a process where larger sporozoites divide into many identical cells called schizonts, which contain anywhere from 8-32 merozoites.

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Photo of a schizont

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it does this to prevent the human's blood from clotting. The excretion of saliva when mosquitos bite is normal behavior, and is not caused by plasmodium

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it does this to prevent the human's blood from clotting. The excretion of saliva when mosquitos bite is normal behavior, and is not caused by plasmodium

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The previously healthy female anopheles mosquito is now an infected one, acting as a vector for plasmodium, and is now ready to spread plasmodium to other human hosts

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The previously healthy female anopheles mosquito is now an infected one, acting as a vector for plasmodium, and is now ready to spread plasmodium to other human hosts

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The oocysts burst from the excess production of sporozoites

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The oocysts burst from the excess production of sporozoites

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The ookinetes develop into oocysts, cysts on the outside of the anopheles mosquito's gut which produce and contain sporozoites

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The ookinetes develop into oocysts, cysts on the outside of the anopheles mosquito's gut which produce and contain sporozoites

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The male and female gametocytes fuse inside the anopheles mosquito to form zygotes in the mosquito's gut

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The male and female gametocytes fuse inside the anopheles mosquito to form zygotes in the mosquito's gut

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A healthy female anopheles mosquito bites the plasmodium-infected human and sucks up male and female gametocytes

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A healthy female anopheles mosquito bites the plasmodium-infected human and sucks up male and female gametocytes

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Least likely outcome per RBC (0.1%-0.3% chance)(2)

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Least likely outcome per RBC (0.1%-0.3% chance)(2)

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Most likely outcome per RBC (99.7% chance) (2)

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Most likely outcome per RBC (99.7% chance) (2)

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The merozoites develop into early versions of ring-like structures called trophozoites inside the RBCs

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The merozoites develop into early versions of ring-like structures called trophozoites inside the RBCs

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The merozoites enter the erythrocytes (red blood cells or RBCs) 

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The merozoites enter the erythrocytes (red blood cells or RBCs) 

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The merozoites burst out of the liver and into the blood stream

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The merozoites burst out of the liver and into the blood stream

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The sporozoites successfully transform into merozoites, another form of the plasmodium life cycle. 

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The sporozoites successfully transform into merozoites, another form of the plasmodium life cycle. 

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Sporozoites travel to the liver, specifically the liver cells called hepatocytes, and reproduce asexually

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Sporozoites travel to the liver, specifically the liver cells called hepatocytes, and reproduce asexually

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Sporozoites, a stage of the plasmodium life cycle, enter the body

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Sporozoites, a stage of the plasmodium life cycle, enter the body

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The mosquito excretes saliva containing plasmodium sporozoites into the humans blood

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The mosquito excretes saliva containing plasmodium sporozoites into the humans blood

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A female anopheles mosquito infected with plasmodium protozoa, acting as a vector, bites a human

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A female anopheles mosquito infected with plasmodium protozoa, acting as a vector, bites a human