生物学と医学

概要

Malaria: What are the Needs for Diagnosis, Treatment and Control?

Eshetu Molla

According to the World Health Organization, malaria has been noted for many years in the world causing a life threatening effects. It is a mosquito-borne disease caused by Plasmodium species. Despite progress in fighting malaria worldwide, the disease kills 236,000-635,000 peoples annually. Children less than five years of age living in Sub-Saharan Africa are mainly the affected groups. By 2015, malaria accounted for just 10% of under-five deaths in sub-Saharan Africa. Although rapid diagnostic and molecular tests for malaria are increasing in prevalence and importance, the standard method for malaria diagnosis in much of the world remains the examination of thick and thin blood films. As recommended by the World Health Organization, the management of suspected malaria cases relies on early diagnosis and effective treatment based on artemisinin-combined therapy (ACT). Likewise, including Ethiopia, most countries with Plasmodium falciparum malaria has adopted ACTs as a first-line treatment; with Arthemeter Lumefantrine (AL) now the first line treatment for uncomplicated falciparum malaria in Ethiopia. In areas where chloroquine is still effective, P. vivax malaria should be treated with this drug. Where resistance to chloroquine has been documented, P. vivax malaria should be treated with an appropriate ACT. Most reviews and findings revealed that the control and elimination of malaria require expanded coverage of and access to effective malaria control interventions such as insecticide-treated nets (ITNs), indoor residual spraying (IRS), intermittent preventive treatment (IPT), diagnostic testing and appropriate treatment. In malaria endemic areas, parasite resistance to most commonly used anti-malarial drugs, insecticide resistance in the vector and changing of biting behavior of the vectors are involving problems to eradicate malaria. As a result, the massive incidence of malaria in the Third World makes vaccine as the major tool for effective disease control and eradication. This paper reviews the available information on the malaria epidemiology, clinical manifestation, diagnosis, treatment and control strategies and gives insight for the needs of sustained diagnosis, treatment and control.