Malaria: Prevention and treatment

How can malaria be prevented?

Although it kills nearly one million people every year, malaria is preventable and curable. Some of the main methods of prevention are:

• Insecticide-treated bed nets. Most malaria-carrying mosquitoes bite at night, so insecticide-treated mosquito nets can be a life-saving barrier. It is important that nets are easy to get hold of – either offered at a subsidised price or given away for free – and that they are designed in a way that is suitable for the local context. Awareness campaigns are also important to make sure that they are used effectively.
• Treating women during pregnancy. Pregnant women have lower immunity. Doses of anti-malarials during pregnancy can protect both mother and child.
• Health education. An important part of preventing malaria and malaria deaths is improving people’s understanding of the disease. This includes how to use nets properly to avoid being bitten, awareness of the symptoms, how to get treatment, the importance of getting treatment quickly (particularly for children), and the need to finish a full course of drugs and not stop when you feel better.
• Environmental methods. Getting rid of pools of stagnant water, clearing bushes from around houses and planting lemon grass can all reduce the number of mosquitoes nearby.

How is malaria treated?

There are a number of effective drugs available to treat malaria but speedy diagnosis and immediate treatment are essential. The majority of deaths from severe malaria in children are caused by not getting to a clinic in time. Some forms of malaria can be fatal within days or even hours once they develop, but malaria can usually be cured if treated quickly. Those who survive may still suffer lasting health problems.

For people living in remote areas with little or no access to health services, more mobile staff and health outposts would reduce the time between diagnosis and treatment, and save lives.

How big a problem is drug resistance?

Resistance to the cheapest and most widely used anti-malarial drug, chloroquine, is now common across Africa. New treatments have been developed but they come at a high cost. An adult dose of a newer drug may be 10 to 20 times more expensive than older anti-malarials.

One reason for the rise of drug resistance is that people do not finish their course of treatment but stop when they start to feel better. Poorly trained pharmacists and store owners may also allow patients to buy just a portion of a course of drugs, as that is all they can afford, which contributes to dangerous drug resistance.

What is the cost of treatment?

Cost varies enormously, but in many of the countries most affected, the cost of treatment is unmanageable for poor and marginalised communities. In Sierra Leone, for example, the cost of treating a child with malaria has been estimated as the equivalent of half a month’s average salary.