2) the warm weather makes it favourable for mosquitos to breed. 

a mosquito takes microscopic malaria parasitic blood from an infected human with malaria parasites -> the malaria parasites enter the mosquito and infects -> this infected mosquito bites another human and the malaria parasites that is in the mosquitos saliva are then injected into that person -> these parasites move to the liver where they multiply and spread into the rest of the bloodstream.

conditions for transmission: 

- stagnant water (pots, uncovered drains) for the mosquitoes to breed

- no heavy rain or water that can kill the eggs of the mosquitos 

- high rainfall so relative humidity of 50-60% so the mosquitoes can be most active in spreading malaria as well as living longer to infect more people

- temperatures of 22 to 30 degrees

we are more vulnerable due to climate change, as well as the mosquitos being more resistant to insect repellents as they are evolving to combat the drugs.

Malaria imposes substantial costs to both individuals and governments.

Costs to individuals and their families include purchase of drugs for treating malaria at home; expenses for travel to, and treatment at, dispensaries and clinics; lost days of work; absence from school; expenses for preventive measures; expenses for burial in case of deaths.

Costs to governments include maintenance, supply and staffing of health facilities; purchase of drugs and supplies; public health interventions against malaria, such as insecticide spraying or distribution of insecticide-treated bed nets; lost days of work with resulting loss of income; and lost opportunities for joint economic ventures and tourism.


for example, the worsening case of malaria in nigeria where it  had the highest number of global malaria cases (27 % of global malaria cases) in 2019 and accounted for the highest number of deaths (23 % of global malaria deaths). 

• socio economic impact 
  - Sinton calculated a total loss of Rupees 1237 lacs (£10 million at the then prevailing exchange rates, and ∼US$27.49 million).

2)social factors- lack of proper sanitation: waste water is not disposed of properly and stagnant pools of water may form, favourable breeding grounds for mosquitoes.

economic factors- limited provision of and access to health care: lack of health services in rural areas and cost of malaria treatment

environmental factors- overcrowded living conditions: people tend to share the same spaces and use the same items, also tend to interact with each other more often and more closely this diseases spread quickly and easily.

poor drainage and stagnant water: places where there is low awareness of malaria and no precaution is taken to remove pools of stagnant water this mosquitoes breed quickly and without interruption

effect of climate: temperature, rainfall and relative humidity have a direct impact on mosquitoes. monsoons, large amounts of rainfall—more breeding grounds/flush out the breeding grounds. temperature—higher temperatures shorten development time of the parasites in mosquitoes, become active and infectious sooner. humidity—higher humidity level leads to mosquitoes having a longer lifespan, and to infect more people

However, antimalarials only reduce your risk of infection by about 90%, so taking steps to avoid bites is extremely important, as the more people step up to prevent themselves  getting affected by malaria, there would be a significant decrease in transmission of the virus.

a variety of sociobehavioral barriers to prevention and treatment of malaria exist at individual, household, sociocultural, health infrastructure and policy and programmatic levels. for example, barriers include limited knowledge of prevention measures, negative perceptions of drug safety, logistical challenges (Reasons for spread) relating to seeking treatment, poor delivery of supplies, insufficient funding, and slow scale-up of programs, among others. 

case study: China

• success of case management in china was largely due to the determination of government to fully eradicate malaria
• in 1967: "623 project"
  - nation-wide research program which aimed to find new treatments for malaria
  - involved 500+ scientists
  - led to the discovery of artemisinin – the core compound of artemisinin-based combination therapies (ACTs), the most effective antimalarial drugs available today.
• in 1980s: china was the first country to extensively test the use of insecticide-treated nets (well before WHO recognized and encouraged its use)
  - by 1988, more than 2.4 million nets had been distributed nation-wide
     > use of such nets led to substantial reductions in malaria incidence in the areas where they were deployed
• China provides a basic public health service package for its residents free of charge
  - as part of this package, all people in China have access to affordable services for the diagnosis and treatment of malaria, regardless of legal or financial status
• strict adherence of the "1-3-7 strategy"
  -  “1” signifies the one-day deadline for health facilities to report a malaria diagnosis
  - by the end of day 3, health authorities are required to confirm a case and determine the risk of spread
  - within 7 days, appropriate measures must be taken to prevent further spread of the disease.

source: https://www.who.int/news/item/30-06-2021-from-30-million-cases-to-zero-china-is-certified-malaria-free-by-who

FAILURE OF MALARIA CASE MANAGEMENT

case study: USA
• National Malaria Eradication Program was a cooperative undertaking by state and local health agencies of 13 southeastern states and the Communicable Disease Center of the U. S. Public Health Service, originally proposed by Dr. L. L. Williams. The program commenced operations on July 1, 1947
  - application of DDT to interior surfaces of rural homes
  - drainage, removal of mosquito breeding sites, and spraying (occasionally from aircrafts) of insecticides.
• About 2,000 cases of malaria are diagnosed in the United States each year.

ps: I have no clue what the US is doing about it bc the website is so confusing 😵‍💫😵‍💫😵‍💫 so if u wna find out more: https://www.cdc.gov/parasites/malaria/index.html

aside from the lives lost, malaria affects medical costs, causing lost income, and reduced economic output. the annual direct and indirect costs of malaria in Africa are estimated to be more than US$2 billion, according to WHO. malaria is regarded as a cause of poverty. malaria slows economic growth in Africa by up to 1.3 percent per year.

those in poverty are at a great risk as they are least likely to have the means to prevent and treat malaria. thus, children miss school because of the disease, suffering both physically and intellectually, and often cannot contribute to their families’ income (through agricultural work). WHO reports that many families spend up to a quarter of their annual income for malaria treatment.

https://www.prb.org/resources/malaria-basics-global-impact-and-actions/

• Every year malaria is estimated to cost Africa $US 12 billion in lost Gross Domestic Product (GDP). It is estimated the disease has slowed economic growth in Africa by 1.3 percent per year as a result of lost life and lower productivity – what economists call a “growth penalty”.

• For countries with a high malaria burden, the disease may account for as much as 40 percent of public health expenditure, with malaria accounting for up to 50 percent of outpatient.
In Tanzania, for example, malaria accounts for 30 percent of the national disease burden.

• Figures in Tanzania also show that malaria accounts for 43 percent of under-five outpatient attendance, 35 percent of under- five hospital admissions and 37 percent of under-five hospital death.
https://www.malariaconsortium.org/userfiles/file/Past%20events/factsheet2%20-%20malaria%20and%20poverty.pdf

with the measures taken to eradicate malaria such as the use of mosquito nets, mosquito repellents as well as drugs, the world has made tremendous progress in the fight against malaria in the past 15 years. based on the WMR (world malaria report), malaria cases were reduced by 41 percent and mortality rates were reduced by 62 percent between 2000 and 2015. 

Malaria is among the principal causes of morbidity and mortality in the DRC, accounting for 44 percent of all outpatient visits and for 22 percent of deaths in 2018. Approximately 97 percent of the population lives in zones with stable malaria transmission lasting 8–12 months per year. The highest levels of transmission occur in zones situated in the north and centre of the country. 

Between 2016 and 2019, the malaria case burden increased by 7% from 305 to 326 per 1000 of the population at risk. Death rates remained stagnant, at around 0.51 per 1000 of the population at risk. 

Since the anopheles mosquitoes are nocturnal, malaria transmissions usually occur at night when people are sleeping. Thus, the use of insecticide-treated nets (ITNs) are used in the form of bed nets to reduce the risk of getting mosquito bites at night.

This is proved effective in Nigeria as ITNs have been shown to reduce malaria mortality rates by approximately 20%.
source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4718327/