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The problem of rising deaths due to Malaria in Mumbai, India

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Introduction

The problem of rising deaths due to Malaria in Mumbai, India Malaria is a global problem, with around half the world's population (3.3 billion) at risk from the disease. This leads to about 250 million malaria cases and 1 million deaths every year. The majority of deaths are children under the age of 5. Around 500 children die every hour, 3000-10000 per day. (1) However, malaria is disproportionately concentrated in poorer countries (2) with many countries in Africa and South-East Asia the most vulnerable. In India, the incidence of malaria has stayed relatively similar over the last decade, however Mumbai has seen a dramatic increase over the last 10 years. Out of the four major cities in India, Mumbai is the only city where malarial deaths have been increased in the last decade,(3) as shown by the graphs below. (4) (4) Mumbai is the world's second most populous city, which has the highest number of people living in absolute poverty. (5) (6) The table above shows how Mumbai is by far the city with the most malaria related deaths in India, and how the amount of deaths rose sharply in 2009, and the 2010 data is incomplete. In 2002, Chennai and Delhi had recorded zero deaths from malaria whereas Mumbai had recorded 18 deaths. In 2007, Delhi and Chennai maintained their nil statistics in malarial deaths, while in Mumbai the deaths had increased dramatically to 122. (3) In the 70's Maharashtra was declared a malaria free state by the world health organization. (7) In 2010, Mumbai was hit by one of the highest cases of malaria so far. In July alone there were more than 17,000 cases of malaria in Mumbai, and in July 2009, there was just 4,380 cases. In a normal year, malaria deaths only start to appear in monsoon season (June - November), however in 2010, 19 people had died in Mumbai between January and May.(3) ...read more.

Middle

However, most of these go to sub-saharan Africa, and not Mumbai, as Africa is said to need it more. Also the use of some insecticides such as space spray, is short-term, and therefore need to be sprayed more regularly. Also, there is a big problem with ITNs in that they to need to be regularly applied with insecticide to be effective. This therefore means training the community into applying the insecticide, and some users may forget, or not feel the need to re-apply, which puts them back at risk. Implications - Environmental Insecticides can cause damage to the wider environment as insecticides are not specific to the mosquito, and therefore, when applied to a wider area, other animals are killed. Another affect that can occur is when the insect is not quite killed, and is then eaten by another animal, then the animal that ate the insect can also become damaged due to the poison in the insecticide. This can travel up the food chain, and soon a whole species can be at risk. An example of this is the bald eagle, which had a large proportion of its population wiped out due to eagles eating fish which had been infected by insecticides through eating insects. (17) Also with malarial sprays, according to weather conditions, the spray may spread and effect the wider environment. In order to solve this I think that weather conditions such as wind speed/direction should be taken into account when applying large amounts of insecticidal spray. In my opinion, I think that because of the considerable environmental damage often caused, large-scale insecticide operations should be limited, and smaller scale insecticides should be used instead. Perhaps the only time when large scale insecticides should be used could be in an epidemic. Insecticide-treated mosquito nets have a much less environmental effect than other forms of insecticide such as space spray. The nets specifically target the mosquitoes and therefore, it is very rare that any other species is affected by this technique. ...read more.

Conclusion

Plasmodium also replicates at a fast rate, meaning ensuring transmission in to the parasite's life cycle is difficult. Despite these difficulties, the strategic goal from the malarial vaccine community is to 'develop a 80% effacious malaria vaccine by 2025 that would provide protection for at least 4 years (22) This time target shows that a malarial vaccine is still a long way off, but biologists are looking for a more immediate vaccinated solution. An 'edible vaccine' is being developed by researchers from two laboratories in France. It consists of a spoonful of genetically modified starch, and has successfully vaccinated and protected mice. The starch is derived from a green algae called chlamydomonas, which 'can be grown on scales ranging from a few millilitres to 500,000 litres and the starch grain can easily be produced from the plant extract and purified in large quantities'.(23) Researchers are also trying to produce a vaccine that recognizes the antigens associated with the most severe forms of malaria. This will hopefully be able to keep an infant alive long enough for a natural immunity to develop. A different approach is to prevent the infection of the mosquito, by vaccinating against the gamont forms of the plasmodium. This would block the transmission. (11) Some vaccine that are in development aim to prevent liver cells becoming infected. These vaccines are called pre-erythrocytic vaccines. Others aim to stop the reproduction of the parasite in red blood cells, which is called a blood-stage vaccine. Finally, the last type of vaccine in development seeks to kill the parasite after they have bitten an infected vaccinated-person. This is called a transmission-blocking vaccine. Overall there is no single solution to the malaria problem in Mumbai, but a combination of insecticides and Antimalarial drugs is currently the most effective way of preventing and treating malaria. However, ways of combating malaria throughout the world is under constant review and research. This includes the development of a new vaccine, which is currently in the human trials phase of production. If this vaccine is successful, then there is hope that malaria can be eradicated on a global scale. ...read more.

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