Malaria : Prevention

by CDC

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CDC Activities

History

CDC's origins are closely linked to malaria control activities in the United States. The Communicable Disease Center was established in 1946 in Atlanta, Georgia. It succeeded the Office of Malaria Control in War Areas (MCWA), which was charged with malaria control in the southeastern US during World War II. A few years following CDC's inception, malaria was eliminated from the US, and CDC has now greatly expanded its public health goals. However, malaria remains a major field of activities at CDC.

Domestic Activities

Malaria was eliminated as a major public health problem in the United States in the late 1940's. However, several hundred cases of malaria occur annually in the United States, mostly in returning travelers and immigrants ("imported" malaria). Anopheles mosquitoes capable of transmitting malaria ("vectors") exist in the United States. Thus, there is a constant risk that malaria transmission can resume in the United States.

International Activities

Malaria remains a major health problem in developing countries, and CDC participates actively in global efforts against malaria through:

Work in malaria-endemic countries with the Ministry of Health and local disease prevention and control partners (e.g., the national malaria control program, the reproductive health program responsible for maternal health, the child health program)

Work in malaria-endemic regional settings (e.g., the Mekong River region; the Amazon River basin region)

Work with key multilateral and bilateral Roll Back Malaria (RBM) partners (e.g., World Health Organization (WHO), the United Nations' Children's Fund (UNICEF), the World Bank, the U.S. Agency for International Development (USAID).

CDC currently has staff posted at the Global Fund to Fight AIDS, Tuberculosis, and Malaria; UNICEF; and the World Bank; as well as in three African malaria-endemic countries (Kenya, Malawi, and Tanzania). Their work spans the spectrum of policy development, program guidance and support, scientific research, and monitoring and evaluation of progress toward RBM goals. CDC staff also provides technical assistance to several malaria endemic countries to strengthen their control activities.

Research

The CDC malaria research program aims to improve our understanding of malaria and to yield better methods for fighting the disease. Research often is performed in collaboration with other institutions and combines field and laboratory activities.

Field investigations provide insights in mechanisms of transmission and host responses. They often yield specimens that provide valuable information when studied further in laboratories in the United States and overseas.

The laboratories (augmented by insectaries and animal facilities) conduct more basic studies, whose findings can be in turn verified or expanded during field investigations. The CDC malaria research laboratories serve as a WHO Collaborating Center for malaria.

Control and Prevention

Malaria Control in Endemic Countries

The goal of malaria control in malaria-endemic countries is to reduce as much as possible the health impact of malaria on a population, using the resources available, and taking into account other health priorities.

Malaria control does not aim to eliminate malaria totally. Complete elimination of the malaria parasite (and thus the disease) would constitute eradication. While eradication is more desirable, it is not currently a realistic goal for most of the countries where malaria is endemic.

Malaria control is carried out through the following interventions, which are often combined:

• Case management (diagnosis and treatment) of patients suffering from malaria
• Prevention of infection through vector control
• Prevention of disease by administration of antimalarial drugs to particularly vulnerable population groups such as pregnant women and infants.

Case Management

Persons who are sick with malaria should be treated promptly and correctly. Malaria is often a debilitating disease that, when caused by Plasmodium falciparum, can be fatal. In addition, treatment eliminates an essential component of the cycle (the parasite) and thus interrupts the transmission cycle.

The World Health Organization recommends that anyone suspected of having malaria should receive diagnosis and treatment with an effective drug within 24 hours of the onset of symptoms. When the patient cannot have access to a health care provider within that time period (as is the case for most patients in malaria-endemic areas), home treatment is acceptable.

About the Author

www.cdc.gov
The Centers for Disease Control and Prevention (CDC) is one of the 13 major operating components of the Department of Health and Human Services (HHS), which is the principal agency in the United States government for protecting the health and safety of all Americans and for providing essential human services, especially for those people who are least able to help themselves.