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This article will explore the issues of Malaria in Republic of Malawi, also known as the warm Heart of Africa. It will look at the statistics of how the population has been affected by malaria and what the government and its local and international partners are doing to combat the issue. It will further look at the plans which are being set up to overcome this deadly disease.

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Malawi is a landlocked country in southern Africa covering an area of 118,484 square kilometres with a population of about 18,570,000. 18.1 % of the population live in urban areas while 83.9 % live in rural areas. The main source of income for many Malawians is Agriculture which is done using manual labour. Compared to the United Kingdom, life expectancy in Malawi low. Males have an average life expectancy of 58.7 years while females average life expectancy is 62.7 years.

Map and location of Malawi in Africa

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Malaria is a tropical disease caused by a parasite plasmodium falciparum which is spread by a certain female type of mosquito called Anopheles. This mosquito carries the plasmodium parasite and when one has been bitten by this mosquito, the plasmodium is carried in the bloodstream to the liver and spleen where they multiplies. This causes the cells to burst open and thousands more parasites are released into the bloodstream. These new parasites enter and attack the red blood cells. The parasites continue to multiply and kill off the red blood cells. At this stage the person will start feeling unwell, this condition is known as malaria and If not treated it can be fatal.

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Malaria is a serious tropical disease spread by mosquitoes. If it isn't diagnosed and treated promptly, it can be fatal.
A single mosquito bite is all it takes for someone to become infected.

Symptoms of malaria

It's important to be aware of the symptoms of malaria if you're travelling to areas where there's a high risk of the disease. Symptoms include:

a high temperature of 38C or above

feeling hot and shivery

vomiting

muscle pains

Symptoms usually appear between 7 and 18 days after becoming infected, but in some cases the symptoms may not appear for up to a year, or occasionally even longer.

Read more about the symptoms of malaria.

When to seek medical attention

Seek medical help immediately if you develop symptoms of malaria during or after a visit to an area where the disease is found.

You should still seek medical help even if it's several weeks, months or a year after you return from travelling.

If there's a possibility you have malaria, a blood test will be carried out to confirm whether or not you're infected.

You should receive the results of your blood test on the same day. If you have malaria, treatment will be started straight away.

What causes malaria?

Malaria is caused by a type of parasite known as Plasmodium. There are many different types of Plasmodia parasites, but only 5 cause malaria in people.

The Plasmodium parasite is mainly spread by female Anopheles mosquitoes, which mainly bite at dusk and at night. When an infected mosquito bites a person, it passes the parasites into the bloodstream.

Malaria can also be spread through blood transfusions and the sharing of needles, but this is very rare.

Read more about the causes of malaria and how it's spread.

Malaria risk areas

Malaria is found in more than 100 countries, mainly in tropical regions of the world, including:

large areas of Africa and Asia

Central and South America

Haiti and the Dominican Republic

parts of the Middle East

some Pacific islands

Malaria is not found in the UK - it may be diagnosed in travellers who return to the UK from risk areas.

The TravelHealthPro website has more information about the risk of malaria in specific countries.

Preventing malaria

Many cases of malaria can be avoided. An easy way to remember is the ABCD approach to prevention:

Awareness of risk - find out whether you're at risk of getting malaria before travelling.

Bite prevention - avoid mosquito bites by using insect repellent, covering your arms and legs, and using an insecticide-treated mosquito net.

Check whether you need to take malaria prevention tablets - if you do, make sure you take the right antimalarial tablets at the right dose, and finish the course

Diagnosis - seek immediate medical advice if you develop malaria symptoms, as long as up to a year after you return from travelling.

Speak to your GP if you're planning to visit an area where there's a malaria risk. It may be recommended that you take antimalarial tablets to prevent infection.

Read more about preventing malaria.

Treating malaria

If malaria is diagnosed and treated promptly, virtually everyone will make a full recovery. Treatment should be started as soon as the diagnosis has been confirmed.

Antimalarial medication is used to both treat and prevent malaria. Which type of medication is used and the length of treatment will depend on:

the type of malaria

the severity of your symptoms

where you caught malaria

whether you took an antimalarial to prevent malaria

whether you're pregnant

In some cases, you may be prescribed emergency standby treatment for malaria before you travel. This is usually if there's a risk of you becoming infected with malaria while travelling in a remote area with little or no access to medical care.

Read more about treating malaria.

Complications of malaria

Malaria is a serious illness that can get worse very quickly. It can be fatal if not treated promptly.

It can also cause serious complications, including:

severe anaemia - where red blood cells are unable to carry enough oxygen around the body, leading to drowsiness and weakness

cerebral malaria - in rare cases, the small blood vessels leading to the brain can become blocked, causing seizures, brain damage and coma

The effects of malaria are usually more severe in pregnant women, babies, young children and the elderly. Pregnant women in particular are usually advised not to travel to malaria risk areas.

Read more about the complications of malaria.

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Malaria is a serious tropical disease spread by mosquitoes. If it isn't diagnosed and treated promptly, it can be fatal. A single mosquito bite is all it takes for someone to become infected. It's important to be aware of the symptoms of malaria if you're travelling to areas where there's a high risk of the disease.

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Malaria is the major cause of mortality and morbidity in Malawi especially affecting children under 5 year’s old and pregnant women. According to the Health Management Information System (HMIS) annual bulletin (2009) 30% of all outpatient visits in Malawian hospitals and health care centres are due to Malaria. In addition 52% of under 5 children are admitted in hospitals due to malaria. Malaria further causes 60% of all deaths among children under 5 in hospitals. The Malawi National Malaria indicator survey (2010) suggests that the number of malaria presumptive cases have risen from 3.7 million to 6.1 million between 2005 and 2009, which is an increases of 2.4 million cases.However, due to new measures which have been put in place to combat malaria such as the use of mosquito repellent, treated mosquito nets and better medication has led to the decreased death rates from 5.6% to 3.7% in 2004 and 2009 respectively.

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Before 2015 Malawi’s economy was solely depended on donors and agriculture. However, since 2015 the country depends on farming and having malaria in the country can have some draw backs to the community.

One of the most obvious effect of malaria is that it affects Malawi’s health services in that those people who are ill will need to be diagnosed, treatment and in some cases hospital admissions. This will then affect people from not going to work in their farming fields which will result in less or no food production and children being absent from school, which will have a direct effect to the social economy of the country. Sach (2007) suggested that diseases such as malaria are the key factors that trap developing countries to poverty.

Furthermore, high levels of absenteeism of children in schools will have an impact of improving literacy rates and the education system as a whole. Since under 5 children are the most affected by malaria in terms of deaths, these high mortality rates results in high fertility rates as more families will try and replace the children lost to malaria. This results in a fast growing population which can lead to high youth and adult unemployment.

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The WHO conducted a phase three clinical trial in 7 sub Saharan countries including Malawi for a five year period. The trials main aim was to source information and decisions on vaccines, medical interventions and drugs. The trials focused on 4 main phases;

Phase 1:

A new intervention was research tested in a small group of people in order to evaluate its side effects, safety and also to come up with a safe range of dosage

Phase 2:

The intervention is now given to a larger group of people to find out if it is effective, evaluate its safety further and to finally select the required dosages.

Phase 3:

The intervention eventually   given to a larger number of the targeted population to confirm its effectiveness. More information is collected that will determine whether the drug or treatment can be used safely.

Phase 4:

Further Studies are done after on the drug's effectiveness in different communities and any side effects due to long-term use.

The trial targeted 15000 young children and infants. Infants received the vaccine at 6, 10, and 14 weeks old while younger children received the vaccine between 5 and 17 months old. The trial they found that the younger children aged 5 and 17 months who received 3 doses of the vaccine reduced malaria cases by 39%, which is almost 4 out of 10 cases. While those on 4 doses of the vaccine reduced the malaria cases by 31.5%. However, those who did not receive the forth dose had a reduced protective benefit against malaria, meaning that the fourth dose is needed. The trial found that there was no protective benefits on infants with this vaccine (WHO, 2017)

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NHS (2017).Available at https://www.nhs.uk/conditions/malaria/ [accessed: 27 November 2017]

Sach. J (2007) work on the poverty trap. Available at http://www.malaria.com/questions/malaria-society-effects [accessed: 14/11/2017]
Taylor, T (2017) Malaria in Malawi. Available at https://www.google.co.uk/search?q=malaria+in+malawi+pictures&rlz=1C1GCEA_enGB779&tbm=isch&source=iu&ictx=1&fir=DlRI7_jKdaXK1M%253A%252C21BLn_5AdZwaEM%252C_&usg=__lWpED7Lhju6t6DQOZFTct3myRbE%3D&sa=X&ved=0ahUKEwj4rq_b6srYAhVDIlAKHTTXB28Q9QEINDAC#imgrc=xh1Je9jEukTs5M: [accessed: 07 January 2018]

The Malawi project (2017) statistics. Available at http://www.malawiproject.org/about-malawi/statistics/  [accessed: 07 November 2017

WHO (2017) Q&A on the Phase 3 trial results for malaria vaccine RTS, S/AS01. Available at http://www.who.int/malaria/media/rtss-phase-3-trial-qa/en/ [accessed: 14 November 2017]

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According to the United Nations health agency for regional Office for Africa (2017), Malawi will be one of the 3 countries in the world to take up the first malaria vaccine in the world starting in 2018. This vaccine has been developed to protect children from the malaria causing plasmodium parasite. WHO (2017) further states that the vaccine will be administered through injections and will be used alongside other measures of protecting children against malaria

Women getting tested for malaria

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Learn about the work PMI is doing in Malawi.