November 30, 2017

The World Health Organization (WHO) Global Technical Strategies for Malaria set certain goals for malaria reduction and elimination. Unfortunately, the world is not currently on track to meet milestones set for 2020. While many improvements were made in the last decade, funding shortages to support spraying and insecticide-treated bednets has fallen behind in recent years. The World Malaria Report provides a comprehensive overview of progress in the fight against malaria, including an up-to-date assessment of malaria-related policies in endemic countries.

Trends in Malaria

Between 2015 and 2016, 25 countries reported at least 20% increase in malaria cases. Rwanda and Nigeria reported the highest increases. The African Region continues to report more cases than any other region, with Nigeria reporting the highest number of cases, accounting for over 25 percent of cases worldwide. An additional complication has been the handling of risk areas in complex settings. Locations like Nigeria, South Sudan, Venezuela, and Yemen pose significant challenges and the need for increased support. These recent challenges should serve as a wake-up call for capable nations to step up to the plate and participate in the creation of robust funding for immediate and complex solutions. When operating in complex settings involving significant security issues it’s easy to forget or not focus on health issues and risks. Ensure you have a protocol in place to identify and mitigate these risks appropriately.

Another concern is that health authorities have reported increasing drug resistance cases in the Greater Mekong subregion. This does not mean it is untreatable. Multidrug resistance will likely influence the choices a travel health provider will offer when recommending chemoprophylaxis (malaria prevention drugs) to individuals operating in these areas. Risk of malaria infection is present year-round in Cambodia, Laos, Thailand, and Vietnam and is highest during and immediately following the rainy season, which typically occurs June to November. Regardless of season, ongoing transmission of drug-resistant malaria highlights the importance of constant use of mosquito bite prevention measures, as well as consistently taking malaria prevention medication as prescribed.

Overall, drug or insecticide resistance has not been the cause of the trends found by the WHO. Funding for malaria response worldwide has plateaued since 2010, the current funding of US$ 2.7 billion dollars is less than half the set target. If significant increases in funding are not achieved, countries with high burden of malaria may risk continuing the increasing trend seen in recent years, making the goals set for 2020, impossible to reach.

Protection and Prevention

Avoid Mosquito Bites

  • As weather permits, wear clothing that covers arms and legs. Wear socks, and avoid wearing sandals. Use an insect repellent containing DEET (around 35 percent) on clothing and exposed skin when outdoors. These precautions are especially important during the day.
  • Use air conditioning systems or window and door screens to keep mosquitoes from entering buildings. Use insecticide area sprays. Regularly check for and eliminate mosquitoes found indoors.
  • If sleeping in an area with malaria activity, make sure that rooms are completely sealed and/or sleep under a properly deployed mosquito bed net.
  • Check for and remove any standing water inside and outside your home, office, or work site on a weekly basis.
  • Contact health authorities if you notice high numbers of mosquitoes.

Remove Mosquito Breeding Sites

  • Check for and remove any standing water inside and outside your home, office, or work site on a weekly basis. 
  • Contact health authorities if you notice high numbers of mosquitoes. 

If you develop a fever within a week of being in an area where malaria is a threat, especially if you remember being bitten by a mosquito: Contact your healthcare provider. Be sure to tell the physician that you have been to an area with malaria.

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