Bed nets and Malaria

The natural transfer of malaria from one person to another is only through mosquito bite. This information is not very much known to the community. There are still many misconception regarding malaria transmission or causation in the community. Even if the person know that one gets malaria through mosquito bites they still take the risk by not using mosquito nets even if they own one. They pose problem in malaria elimination.
Mosquito net is very effective in prevention of malaria especially if treated as long as a significant segment of the community (>80%) sleeps in it on a nightly basis. The bigger the segment of population sleep inside the mosquito net then the greater the chance for the elimination of malaria in the community. Untreated nets is a barrier to the access of the mosquito to the human. Treatment of nets with insecticide converts it to a trap with human bait inside thus killing the mosquito vector. Using insecticidal nets alone without corresponding treatment of infected persons will delay the elimination of malaria since untreated malaria infection may last for years. In the presence of undetected malaria carriers transmission of malaria will persist in the community maybe at a low level but will soon explode when control methods are relaxed. Campaign for the use of mosquito net is one of the pillar in the elimination of malaria and the most significant information activity towards malaria elimination.

There are, however, mosquito vectors that will not be affected by mosquito nets as preventive measure. They are the vectors that feed outdoors and rest outdoors and the early biters. There are still no vector control strategy for these mosquitoes. The people however must know that they get malaria from mosquito.This information may lead the people to react and prevent or protect themselves from mosquito bite. Use of long sleeve shirt and long pants will provide a barrier form mosquito. Practices like burning materials to create smoke that will drive away mosquitoes or burning the ordinary mosquito coil may help. Application of insect repellents may help. Research on this topic is needed.

The Spread of Malaria

Malaria is an intracellular parasite. It lives inside its host cell. In humans, they are either inside the red blood cells or liver cells. They get out of the parasitized cell only when it ruptures releasing merozoites. Their stay outside the cell is very brief not lasting longer than an hour. This time is not enough for the immune system to react to the presence of the parasite. Once they get inside another cell then they can no longer seen by the immune system.
Even if the parasite is inside the cell they can travel long distance through either through the flight of the infected mosquito or through the movement of the human host in its activities. The spread of the parasite through the mosquito vector is limited by its flight range as well as the life span of the vector. The spread of the parasite through the human host is limitless considering the ease of transportation nowadays and the lifespan of the human.
Using the above mentioned information there is great chance of the malaria parasite to spread to areas where there is vector mosquito. This information likewise help malaria control officers to eliminate the parasite in a community. The first and foremost step is to identify the communities with indigenous malaria case/s in past two weeks. These are the communities with malaria transmission. The second step is to apply vector control either indoor residual house spraying or insecticide treatment of mosquito nets. The third step is to request the community members to sleep inside the mosquito nets every night regardless of the vector control method applied. The fourth step is to conduct case finding and prompt treatment of those found positive for malaria. The fifth step is to conduct follow up smear every week to those found positive plus house to house case finding activity. The sixth step is to conduct case finding every two weeks until after two to six months from the last malaria case in the community. The seventh step is to set up surveillance system to detect introduce malaria case/s before the second week of illness.
TThe steps mentioned earlier will lead to elimination of malaria in the community.It will seem complicated or costly but with step by step application this will only be burden in the initial implementation and cost of intervention will diminish at the end of sixth month.