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Malaria Awareness MonthThis November, we are observing the 2021 Malaria Awareness Month to continue promoting Malaria awareness, prevention and control with the theme: “Reaching for Zero Malaria”. Malaria is a parasitic disease caused by the genus Plasmodium that attacks human red blood cells leading to anemia in the long term and other complications which can lead to impaired physical and mental growth and development in children and maternal morbidity and mortality in pregnant women. It is transmitted by Anopheles mosquitoes from endemic areas especially during “kaingin” activities in farmlands.

Worldwide, Malaria is considered as the world’s most important tropical parasitic disease. In the Philippines, 2,932 confirmed indigenous Malaria cases and 2 Malaria related deaths were reported as of August 2021. Endemic areas include several areas in Region IV-B, Bataraza and Brooke’s Point in Palawan and Sultan Kudarat as of 2020. Malaria used to be an endemic infectious disease in Marilog and Paquibato districts in Davao city until DOH declared Davao as Malaria-free in 2019. This success was attributed to prevention and intervention programs using “new technologies, use of insecticide-treated nets, early detection malaria suspects; case surveillance and follow up of last cases, and effective treatment”.

An individual can get infected with the malaria parasite through an infected Anopheles mosquito that breeds in rivers and lakes and forest fringes. It can also be transmitted through blood transfusion and mother-to child transmission before or during birth. Any individual with a history of travel to a malaria-endemic area is at-risk of developing malaria up to 2 years or longer after leaving the area because the parasite has a tendency to stay “inactive” inside the body for years. Symptoms may begin 9 - 14 days after infection which includes high fever, headache, chills, and shivers, nausea, and vomiting. If left untreated, it may progress to severe symptoms such as: severe vomiting and diarrhea, generalized convulsion, delirium, and impaired consciousness, followed by coma and possibly death. Through early diagnosis, malaria can be treated with anti-malarial drugs which can cure and prevent transmission of the infection. Antimalarial drugs can also be used as a preventive measure if an individual is scheduled to travel to a malaria-endemic area. Other personal protective measures include:

● Early diagnosis and treatment to prevent transmission of the parasite and to prevent severe fatal malaria
● Use of insecticide-treated nets and long-lasting insecticide-treated nets
● Indoor residual spraying (IRS)
● Wearing of light-colored clothing, which cover most of the body since dark colors attract mosquitoes
● Using topical insect repellents or lotions with DEET at 35 % concentration
● Using insect spray with pyrethrum in living areas
● Use of permethrin insecticide as repellant spray for clothing

Nutrition for Malaria prevention and treatment

Aside from mosquito control, strengthening the individual’s natural defense against infection is also important to prevent severe and fatal malaria especially in high-risk groups such as children and pregnant women. Based on a 2016 study by Unger et al., undernutrition in pregnant women may worsen their baseline susceptibility to malarial infection which may negatively affect the developing fetus leading to poor gestational weight gain and increased risk of maternal mortality. It is also associated with maternal anaemia, fetal loss, small for gestational age and preterm births according to the WHO. A systematic review by Shankar in 2000 suggested that “protein-energy malnutrition is associated with greater malaria morbidity and mortality in humans”. Moreover, studies on vitamin A or zinc supplementation show that these nutrients can help reduce malaria symptoms when combined with proper medical treatment. Thus, it is also important to provide nutritional interventions to address underlying maternal or child malnutrition in the community to lower susceptibility and prevent malaria infection and to support recovery from the illness during treatment.

Here are some foods to boost our immunity against diseases such as malaria:

1. Citrus fruits such as dalanghita, kalamansi, ponkan, lemon, orange and pomelo are rich in Vitamin C which boosts the production of white blood cells that fight off infections.
2. Camote or sweet potato, squash, papaya, carrots as well as green leafy vegetables are rich in beta carotene which converts to vitamin A, a vital nutrient for strong immune system.
3. Garlic, ginger and turmeric have antioxidants and anti-inflammatory properties which also help boost immunity.
4. Spinach, broccoli, nuts and peppers are high in vitamin E which is powerful antioxidant that helps the body fight off infections.

Generally, eating a balanced diet with proper daily variations can help boost our immunity against various diseases, including Malaria.

“Nutrition is the only remedy that can bring full recovery and can be used with any treatment.
Remember, food is our best medicine!”
- Bernard Jensen

/AET

References:

• Belizario, V.Y. & dE Leon, W.U. (2015). Medical Parasitology in the Philippines, 3rd ed. Quezon City: University of the Philippines Press.

• Department of Health (2021). 2021 Impact Indicators. DOH National Malaria Control and Elimination Program. Date Accessed 05 November 2021. Retrieved from https://nmcep.net/.

• Revita, J.C. (2019). DOH: No Malaria in Davao region. SunStar Davao. Date Accessed 05 November 2021. Retrieved from https://www.sunstar.com.ph/article/1806629/Davao/Local-News/DOH-No-Malaria-in-Davao-region

• Portillo M.S. (2020). November is Malaria Awareness Month. DOH National Malaria Control and Elimination Program. Date Accessed 05 November 2021. Retrieved from https://nmcep.net/stories/story.php?id=125

• Unger, H. W., Ashorn, P., Cates, J. E., Dewey, K. G., & Rogerson, S. J. (2016). Undernutrition and malaria in pregnancy–a dangerous dyad?. BMC medicine, 14(1), 1-9.

• World Health Organization (2017). Meeting report of the WHO Evidence Review Group on Malaria in Pregnancy. Malaria Policy Advisory Committee Meeting. Date Accessed 05 November 2021. Retrieved from https://www.who.int/publications/m/item/meeting-report-of-the-evidence-review-group-on-malaria-in-pregnancy

• Shankar, A. H. (2000). Nutritional modulation of malaria morbidity and mortality. The Journal of infectious diseases, 182(Supplement_1), S37-S53.

• National Nutrition Council. NNC COVID-19 Nutrition Advisory No. 6.