MalariaPDF print version
Malaria is still a significant health problem in many tropical countries. After a successful beginning, the programs instituted between 1955 and 1969 toward the goal of eradicating malaria ultimately ended in failure. The continuation of ongoing control programs was not implemented, or only partially put into operation in many countries for economic reasons. An increase in malaria has even been observed in some countries. Besides inadequate controls, improvements in the living conditions of the vactor mosquito due to human intrusions into the ecology are the prime factors responsible for this. In this context, the increase of food and energy production and the creation of fresh water surfaces in conjunction with irrigation programs and energy extraction from water power have led to a considerable expansion of mosquito breeding places.
The risk world-wide
The World Health Organization has estimated that 300 - 500 million persons become ill with malaria annually. P. falciparum Malaria, caused by the parasite plasmodium falciparum, is the most dangerous form of malaria and almost exclusively responsible for the fatalities, with a current estimated annual rate of some 2 million. The most heavily afflicted persons are children. A partial immunity, brought about by a weakened or non-apparent course of the disease, only happens after a large number of infections.
The risk for travelers
Over the last few years, an annual rate of approximately 1,000 cases of malaria infections imported by travellers were reported in Germany. The actual rate is probably much higher. In addition, it is not known how
many german travellers fall ill during a journey to the tropics and are then treated in the country they are visiting. In the cases of german tourists returning home with the disease, the prevalent form by far since 1984 is P. falciparum malaria and is primarily accountable for the increase over the past years.
Over 60% of all malaria importations and some 90% of the p. falciparum malaria cases were acquired in tropical Africa. Fatalities occurred almost exclusively as a result of p. falciparum malaria. While the imported p. falciparum malaria still ended in death in almost 10% of the cases in the seventies, the frequency of fatality in the past few years could be reduced around 2 to 3%. Fatality resulting from imported malaria is almost always preventable if the proper therapy is administered in time. When it does occur, it is almost invariably because a diagnosis was not made or was made too late because the possibility of malaria had not occurred to anyone.
In view of the fact that these measures of protection against mosquito bites are practically free of risks, they should be carried out meticulously by all people travelling in areas of endemic malaria.