It’s that time of year again when some healthcare facilities begin mobilizing teams to provide medical care in underserved countries around the world. Without proper preparation, these health care workers are vulnerable to infectious diseases that are common in the countries they serve. Malaria, a life-threatening illness caused by parasites and spread by the bite of infected mosquitos, is one illness for which healthcare workers are at risk. Non-immune travelers from malaria-free areas, such as the United States, are exceptionally vulnerable to the disease when they become infected.
According to the World Health Organization (WHO) Malaria kills more than 580,000 people annually; most deaths occur among children in Africa where a child dies every minute from the disease. Malaria is spread exclusively through the bites of Anopheles mosquitoes, which contain Plasmodium parasites. There are four species of Plasmodium parasites that cause malaria in humans. Of those, the Plasmodium falciparum and Plasmodium vivax are most common; but Plasmodium falciparum is the most deadly.
About half of the world’s population is at risk for malaria; most cases occur in sub-Saharan Africa, but Asia, Latin America, and to a lesser degree the Middle East and portions of Europe are also affected.
A person usually experiences symptoms of malaria 10 to 15 days (but symptoms can occur as early as 7 days) after being bit by the infected mosquito. The initial symptoms, fever, headache, chills, and vomiting may be mild, causing them to be overlooked. If not treated within 24 hours, P. falciparum malaria can progress rapidly to severe illness and even death. Symptoms of severe disease include:
As you can see, prompt recognition and treatment are keys to saving lives from malaria. When symptoms develop, the best treatment available is artemisinin-based combination therapy. However, the WHO recommends diagnostic testing to confirm the disease before initiating treatment. Rapid tests produce results in less than 15 minutes.
So, how do you protect your healthcare workers before sending them abroad? There are no licensed vaccines against malaria. First, recommend that your team seeks advice from a travel clinic or practitioner experienced in travel medicine, in order to see whether preventative antimalarial medications are necessary for the specific destination. If antimalarial agents are recommended, they should be taken before, during, and after travel. These medications work by suppressing the blood stage of the malaria infection, and subsequently prevent the disease.
Moreover, make sure your team is educated about other malaria prevention measures:
Traveling abroad to help underserved people is a life-changing experience, despite the associated health risks. Where is your team traveling this year? What services are you providing for the underserved? We’d love to hear stories from your team when they return.