Egypt becomes 2nd country in 2024 to be declared ‘malaria-free’

Sub: Sci

Sec: Human health

Egypt Declared Malaria-Free by WHO

On October 20, 2024, Egypt was officially declared malaria-free by the World Health Organization (WHO), becoming the second country in 2024 after Cabo Verde and the fifth African nation to receive this certification.
Egypt’s malaria-free status is the result of nearly a century of continuous efforts to eradicate the disease.

Historical Efforts Against Malaria:

4000 BCE: Malaria was present in Egypt, especially in Nile river communities.
1920s: Egypt began reducing human-mosquito contact, banning rice cultivation near homes.
1930s: Malaria became a notifiable disease, and control stations were established.
World War II: Malaria cases surged to over 3 million due to factors like population displacement and medical supply disruptions.
1950s-1960s: Environmental management, mosquito surveillance, and DDT campaigns reduced malaria significantly.
Aswan Dam (1969): New risks arose due to stagnant water, but joint efforts with Sudan controlled the threat.
2014: A brief outbreak in Aswan was swiftly contained, and no malaria case was diagnosed for two years after that.

Key Factors Behind Egypt’s Malaria-Free Status:

Egypt’s surveillance system, in collaboration with various stakeholders, allowed early detection of imported cases.
95% of Egypt’s population now lives within 5 kilometres of a primary health centre, with free diagnosis and treatment for all, including undocumented migrants.
Integrated Efforts: The High Committee for Integrated Vector Management was formed in 2016 to enhance coordination in fighting vector-borne diseases.
Cross-border Cooperation: Egypt continues close partnerships with endemic countries like Sudan to prevent the re-establishment of malaria.
Egypt’s success is seen as a model for other countries, particularly those in Africa, like Nigeria, which carries the highest global malaria burden.

Certification and Global Impact:

To achieve WHO’s malaria-free certification, a country must prove that no local malaria transmission has occurred for three consecutive years and that systems are in place to prevent its return.
With this announcement, 44 countries and one territory worldwide have now been certified malaria-free.

Malaria:

Malaria is a life-threatening disease caused by Plasmodium parasites, transmitted to humans through the bites of infected female Anopheles mosquitoes.
Five species of Plasmodium can cause malaria in humans:

Transmission:

Primary vector: Female Anopheles mosquitoes
Mosquitoes bite between dusk and dawn
Can also be transmitted through: Blood transfusions, Organ transplants, Shared needles, From mother to unborn child

Symptoms

Early Symptoms (typically appear 10-15 days after infection): Fever, Chills, Headache, Muscle aches, Fatigue, Sweating, Nausea and vomiting
Severe Malaria Symptoms: Severe anemia, Respiratory distress, Cerebral malaria, Organ failure, Abnormal blood coagulation

Diagnosis:

Blood tests (microscopy), Rapid diagnostic tests (RDTs), PCR testing for species identification, Antibody tests

Treatment

Medications
- Artemisinin-based combination therapy (ACT)
- Chloroquine (where parasites remain susceptible)
- Primaquine (for P. vivax and P. ovale)
- Atovaquone-proguanil
Vaccines:
- RTS,S/AS01 (Mosquirix) – first approved malaria vaccine
- R21/Matrix-M vaccine showing promising results
- Ongoing research for more effective vaccines

Prevention:

Personal Protection
- Insecticide-treated bed nets, Protective clothing, Insect repellent, Window screens, Air conditioning
Chemoprophylaxis (Preventive Medications)
- Atovaquone-proguanil, Doxycycline, Mefloquine, Chloroquine (in limited areas)
Community Prevention
- Indoor residual spraying, Environmental management, Mosquito breeding site elimination, Community Education

Global Impact:

Source: DTE