Ready or not, here European malaria comes … are we ready?

The questionnaire linked below is now closed. Thank you for your participation, I truely appreciate it.

To those of you who are not familiar to my blog, my name is Victoria Ellis and I am in my final year at the University of Manchester studying Zoology. As part of my final year project I am required to write a post on my blog and access how useful the post was to my readers. To do this I have created a very small questionnaire (7 questions), that simply requires you to answer questions on various aspects of malaria before and after reading this post. This is not a test of your knowledge, but a test of how your knowledge has changed as a result of reading my blog post. I would really appreciate it if you took the time to do this; it will only take a couple of minutes and is completely anonymous.

Instructions: There are 3 questions to answer before reading the blog post and another 4 to answer after reading the blog post.

Please click the following link to commence: Start the questionnaire!

Thank you in advance for your time.

Ready or not, here European malaria comes … are we ready?
Have you ever gone on holiday and had to take antimalarial tablets? Did you accidently forget to take one and panic about getting malaria? What if malaria came to the UK? How would you like having to take antimalarial tablets every day for the rest of your life? That possibility is a lot more likely than you might imagine.

Global warming is causing temperatures in the northern hemisphere to increase and soon those temperatures will be at a sufficient level to support malaria, particularly in the south of Europe (Becker, 2009). As the threat of malaria risk increases, both the public and policy makers in Europe look to scientists for ways of preventing the disease from spreading, and killing the millions of people it currently does in the tropics.

Conventional malaria control
There are two main areas of anti-malaria research; conventional methods and genetic modification. Conventional methods of malaria control include insecticide treated bednets (ITNs) and antimalarial drugs. ITNs are proven to be highly effective in reducing malaria-related morbidity, particularly in children under the age of 5. However a survey in Ethiopia found that only 65% of people with ITNs actually used them. Many mothers use the nets as scarves or bed sheets instead of using them for protection against malaria. Of those that do use the nets, insecticide is rarely reapplied and so the nets quickly become less effective (Deribew et al., 2012).

Another conventional way of controlling malaria is the use of antimalarial drugs. There are several different types of antimalarial drugs affecting different stages of the Plasmodium ( the parasite that causes malaria,) life cycle. A good antimalarial drug will kill Plasmodium early in the life cycle, while it is still in the blood of the human host. This prevents many of the more severe symptoms of malaria infection developing. A good antimalarial drug should also remain active against drug-resistant strains of Plasmodium. There are several problems with antimalarial drugs, particularly due to accessibility in developing countries. This includes the distance to healthcare, financial funds available to those who need the medication and the lack of knowledge about antimalarial drugs. Furthermore there are also issues of drug resistance, meaning that drugs must be continually developed to avoid Plasmodium resistance (Bogitsh and Cheng, 1990).

Genetic modification as a means for malaria control
In the new age of modern technology other methods of malaria control are quickly becoming plausible. This is particularly the case in the field of genetic modification. One potential method of malaria control is through the use of paratransgenesis. This involves the genetic modification of bacteria living within mosquitos to be “anti-Plasmodium”. These bacteria are then reintroduced into wild mosquito populations, with the hope the “anti-Plasmodium” bacteria will spread through the population, blocking the transmission of Plasmodium into humans. However, the bacteria found in wild mosquitos are not well defined and as a result this method is still in its primitive stage (Chavshin et al., 2012, Sadanand, 2010).

A method that is available for use now is the genetic modification of mosquitos themselves. This involves identifying which genes are responsible for the secretion of proteins in areas that come into contact with the parasite – the midgut lumen, hemocoel and salivary gland. If a gene is manipulated that changes protein expression, then that protein could have severe knock-on effects for the parasite, and perhaps even prevent Plasmodium from being able to live within the mosquito. This would completely break down the parasite life cycle. However, by genetically modifying mosquitos, they may be at a disadvantage compared to wild mosquitos. If this is the case the genetically modified mosquitos would be out competed by the wild mosquitos, wasting the time and money spent on the project (Riehle et al., 2003).

Conclusion
In the area of conventional malaria control, the main problematic factor seems to be the issue of accessibility. In the case of genetic modification, there is an issue of the amount of time that will be needed before the mosquitos are ready to be released into areas suffering from malaria. As a result, effective malaria control requires two actions to take place. The most effective way of controlling malaria is likely to be through genetic modification. Until this method is ready for use, a considerable effort should be made in ensuring conventional methods of malaria control are more effective. If these methods are more effective they will control the problem until genetically modified mosquitos are available. Other areas to consider include researching how the genetically modified mosquitos will be released into the wild and how they will interact with wild mosquitos. With the upcoming addition of genetic modification to our tools to fight malaria, we can remain optimistic that should malaria enter Europe, we will have the arsenal to tackle it.

References
BECKER, N. 2009. The impact of globalization and climate change on the development of mosquitoes and mosquito-borne diseases in Central Europe. Environment science and pollution research, 21, 212-222.
BOGITSH, B. & CHENG, T. 1990. Human Parasitology, USA, Saunders College Publishing.
CHAVSHIN, A. R., OSHAGHI, M. A., VATANDOOST, H., POURMAND, M. R., RAEISI, A., ENAYATI, A. A., MARDANI, N. & GHOORCHIAN, S. 2012. Identification of bacterial microflora in the midgut of the larvae and adult of wild caught Anopheles stephensi: A step toward finding suitable paratransgenesis candidates. Acta Tropica, 121, 129-134.
DERIBEW, A., BIRHANU, Z., SENA, L., DEJENE, T., REDA, A. A., SUDHAKAR, M., ALEMSEGED, F., TESSEMA, F., ZEYNUDIN, A., BIADGILIGN, S. & DERIBE, K. 2012. The effect of household heads training about the use of treated bed nets on the burden of malaria and anaemia in under-five children: a cluster randomized trial in Ethiopia. Malaria Journal, 11, 8.
RIEHLE, M. A., SRINIVASAN, P., MOREIRA, C. K. & JACOBS-LORENA, M. 2003. Towards genetic manipulation of wild mosquito populations to combat malaria: advances and challenges. Journal of Experimental Biology, 206, 3809-3816.
SADANAND, S. 2010. Malaria: An evaluation of the current state of research on pathogenesis and antimalarial drugs. Yale Journal of Biology and Medicine, 83, 185-191.

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