Talk:Malaria

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[edit] Someone vandalized

I see "Brandin is cool" under history section right where the 2nd paragraph begins. Yet there is no way of removing that phraze. What is going on? —The preceding unsigned comment was added by 74.108.104.199 (talk)

Vandalism. It's been removed. Fvasconcellos 21:13, 3 February 2007 (UTC)

[edit] wrong info

"Individuals homozygous for HbS have full sickle-cell anaemia and rarely live beyond adolescence" - I don't think this is correct anymore.

[edit] bad wording on liver stage

HLA-B53 is associated with low risk of severe malaria. This MHC class I molecule presents liver stage and sporozoite antigens to T-Cells. —The preceding unsigned comment was added by 207.151.239.71 (talk) 03:52, 1 February 2007 (UTC).

[edit] Book links

I am using the Amazon link temporarily until a nice list of further reading is developed. [User:Fredbauder]

I don't think we should endorse Amazon. Why not give a link to the Library of Congress catalog, Subject Malaria? AxelBoldt 18:10 Oct 8, 2002 (UTC)

[edit] Dutch provinces

I miss the statement in the entry that malaria was eradicated from the Dutch provinces North Holland and Zeeland in the 19th century. 62.195.88.154 21:21, 31 Dec 2003 (UTC)

[edit] UN vs. DDT

The section about buying mosquito nets from the UN sounds suspiciously like pro-UN propaganda. What about DDT? --Uncle Ed 21:53, 12 Mar 2004 (UTC)

I concur that the article fails to achieve NPOV on this issue. Am carving out a 'DDT controversy' section to deal with this. Adhib 17:39, 27 Jan 2005 (UTC)

[edit] User:134.226.1.136

User:134.226.1.136 seems to know a lot about malaria, and has added large amounts of virtually unreadable material to the article. Some of it seems to be a copyvio; there was suddenly a list of 30-40 links. I have reverted everything back to the 27 August version, as User:134.226.1.136's edits have so far been entirely unhelpful. He is invited to come back and work on the article in a more organised fashion (i.e. not saving every 5 minutes). JFW | T@lk 02:18, 12 Sep 2004 (UTC)

[edit] Check the numbers please.

Just checked with the WHO, while reading The Economist and the numbers are different from the ones presented in this article. Please check the link below to see for yourself:

WHO Malaria numbers

--Roman

[edit] Numbers

The number are slightly inaccurate. Malaria infects 300 million people per year and causes 1-3 million deaths per year. I'm new here. Should I just make this change in the article?

Yes, you should. More so if you can back your numbers and reference it. It's also a good idea to sign your talk entries. Do the shortcut and sign with four ~~~~. Alex.tan 04:27, 29 Apr 2005 (UTC)

Global burden of malaria. At the end of 2004, 107 countries and territories had areas at risk of malaria transmission. Some 3.2 billion people lived in areas at risk of malaria transmission. An estimated 350–500 million clinical malaria episodes occur annually; most of these are caused by infection with P. falciparum and P. vivax. Falciparum malaria causes more than 1 million deaths each year. It also contributes indirectly to many additional deaths, mainly in young children, through synergy with other infections and illnesses. World Malaria Report 2005 http://rbm.who.int/wmr2005/html/exsummary_en.htm Petersam 06:05, 2 Jun 2005 (UTC)

Also see Infectious disease for 2002 and 1993 data; 2003 had 1.3 million deaths, 1993 was 2 million deaths. Petersam 06:14, 2 Jun 2005 (UTC)

Whatever the number is, to say "infects 300 million per year" is not accurate because it's not known in most cases whether symptoms are caused by a new infection or an older dormant infection.

"The liver stage of the parasite can become dormant, and re-emerge after 1-18 months (in P. vivax / P. ovale). Recurrence in P. falciparum (in less than a year) and P. malariae (up to 50 years) is due to re-emergence of parasites living at very low levels in the blood." quote from

http://www.malaria.org.za/Malaria_Risk/General_Information/general_information.html

Because clinical symptoms can arise when the parasite reemerges from a previous infection, it is better to say "300 (or 500) million clinical episodes occur per year" just as it is worded on the WHO site. Clinical episodes can arise from new infection or a reemergence of an older infection that is dormant. Uren 17:05, 19 December 2006 (UTC)

[edit] Malaria and syphilis

I read somewhere that malaria was used to "cure" syphilis - the fever made the person so hot that the latter disease was cooked out (being very a non-technical description). Was this actually the case?

There is a discussion of this at Syphilis#Treatment. Julius Wagner-Jauregg won a Nobel prize for it. More detail here. --Arcadian 23:05, 8 December 2005 (UTC)

Yeah I had read somewhere that they used to infect someone with malaria to treat Syphilis. I don't know which one is worse though. I got infected with the clitter (malaria) while taking my high school at Othaya boys secondary school and it was not funny.

Someone added that there are around 50 PfEMP1 protein which is neat. Wondering whether its worth putting this quote right after that statement. It may be an over kill though

New forms come up, and the immune system beats them down again. Because of this a lot of people think you need five years of constant exposure to malaria in its different disguises to gain immunity. [1]

Now, what wikipedia article is completely silent on, is the mechanism of attacking/penetrating the cell. Enter Duffy-Binding Like (DBL) domain, according to this article.[2]. I did consider editing the wiki article to include this info, but thought I would get in trouble for introducing research work. Once the guys in that doman peer review it, it would be good to add it

In order to enter these cells, it first has to bind to the cell through protein interactions which take place on the surfaces of red blood cells and the parasite.

[edit] 'Simultaneous' or 'successive'?

From the article: "The classical description of waves of fever coming every three or four days arises from simultaneous waves of merozoites breaking out of red blood cells during the same day."

Seems more likely that this would be describing a 'successive' pattern of waves, rather than 'simultaneous', but I don't have direct knowledge of this. Can someone verify?

[edit] Re:'Simultaneous' or 'successive'?

I have a suggestion, how about rewriting it something like this: "...many merozoites simultaneously breaking out of red blood cells during the same day."

Mikiemike 21:56, 10 April 2006 (UTC)

[edit] Skewed

Imagine when someone in Africa who has been around malaria his whole life gets a free DVD of Wikipedia, and comes to this article. Instead of any coverage of what is going on in the places where malaria is most widespread, he has to read a section about "travellers to high-risk zones". I can just imagine his reaction. See if you can, too. — BRIAN0918 • 2005-10-24 14:38

[edit] Fred L. Soper

I am just a lay person in this area; but watching the current (week of 10/31/05) series on global health on PBS, I notice that Fred L. Soper played an important role in controlling malaria and other diseases. If a knowledgeable person were to contribute a sentence in the main article and an article on Soper himself, this could be a significant contribution to this article. Bill Jefferys 00:47, 4 November 2005 (UTC)

It's a good point and there is a stub for Fred Soper alone that could be expanded and linked to this article. I've forgotten most of what I knew about him, but will work on this and would like to get editors interested in his bio page too. Art desk 00:55, 1 February 2006 (UTC)

[edit] The Future

I can't see anything in the article about it, but I'm dimly aware of research that's looked at the future prevalence of malaria given climate change (i.e. the return of malaria to the developed world). It's very far from my specialism, so I'd rather not add anything myself, but I think it'd be helpful if someone in the know could extend the article along this axis. Bit cheeky to ask, I know. --Plumbago 17:48, 20 December 2005 (UTC)

From what little I know of the issue (one assignment on one module at university), climate change is certainly predicted to affect malaria prevalence in all sorts of ways (higher prevalence in a wetter East Africa, for instance). I'm no longer all that up on this either, however, so I'll leave it to someone else as well. Procrastinator supreme 13:54, 19 May 2006 (UTC)

[edit] Reorganization

I've started reorganizing this article and related articles, which include Plasmodium, Plasmodium falciparum, Plasmodium vivax, Plasmodium ovale, and Plasmodium malariae. I've moved the details about the microscopic identification of each species to their respective pages, so that they have good descriptions of how they work. I also tried to make the terminology a little more accessible; it would be great if someone with medical training could check my work on that. I also broke up the "Travel to malarial areas" section, moving parts of it elsewhere in the article. Like User:Brian0918 noted above, this section made substantial assumptions that the reader is not a full-time resident of a malarial region. But it did have some good bits on how prophylactic drugs are used, so I rewrote and moved them. Instead, the article needs a discussion of the impacts, or burden, of malaria, which almost exclusively falls on people living in tropical countries. I've started that with text that was already here, and I'll expand it - I have some good sources for this. Finally, a history section would be good; Plasmodium falciparum has a very good beginning on this that I think is best moved here, if only because for much of the history, people knew it only as "malaria", not as as the name of the parasite that causes it. I'll do this soon. I may have messed up the referencing - I promise I'll fix it shortly, but I beg forgiveness if it takes a day or two. CDC (talk) 07:39, 12 February 2006 (UTC)

[edit] Problems Footnoting Henri Vial G25 / te3 in Drug Section

I added a new paragraph on the G25 line of drugs presently in development. What I didn't do is convert the external links to the very nice footnote format which has been used in that section previously. I left them as internal links out of fear that a novice attempt to change them to numbered footnotes which refer to external links in a list at the bottom of the article would foul up the existing numbers. I hope someone more skilled & experienced than I at wikifying will take a shot at it. The info is there, it's just not as pretty as it should be. -- Lisasmall 19:42, 17 February 2006 (UTC)

Thanks for your contribution! I'd been meaning to work on the referencing anyway, because as I noted above I broke it last week, so I just switched over to the new Meta:Cite.php citation format, which I think is substantially easier to maintain, especially as paragraphs get shuffled around. I also moved the paragraph to the "Treatment" section, to make the "Vaccines and other new research" section into just a "Vaccines" section, which I think is a much clearer format. CDC (talk) 22:56, 17 February 2006 (UTC)

I really appreciate the help, and I think you're right about shifting it up to "Treatment" -- I wasn't sure what to do there. -- Lisasmall 11:01, 18 February 2006 (UTC)

[edit] Prognosis

I don't see anything about the prognosis for a malaria patient. Does treatment with anti-malarial drugs cure the disease, or just prevent outbreaks? How long does someone remain a carrier after being infected, and can they only infect mosquitoes during an outbreak? Do people in endemic regions develop immunity over time? Shadwstalkr 02:06, 13 April 2006 (UTC)

[edit] QBC MALARIA TEST

Lot of articles written on QBC MALARIA TEST and about the sensitivity. One can search and find lot of articles in favour. This fluorescent test which is done analysing 60ul of blood, by centrifuging the sample in a capillary tube coated with Acridine Orange is considered as the most sensitive test.

Why this test has not become popular outside India?

I don't know. Might have something to do with price. It certainly doesn't belong in the article in the way it was previously inserted without references or context. InvictaHOG 17:50, 13 May 2006 (UTC)

[edit] Lead section

Does anyone else feel that the lead section talks more about the effects of malaria than what it actually is? So far from the lead a reader can only tell that it's an infectious disease. I think it should be fixed, preferrably by an expert on the subject. -- Ynhockey ^(Talk) 22:25, 29 May 2006 (UTC)

I agree. I'm not an expert, though I've done some reading on the history and impact of the disease. Anyway, I made a try at a new introduction that tries to summarize the article in simple terms, including its causes and effects. Suggestions? There would certainly still be a role for a medical expert to work on some of the more technical bits, some of which are pretty tough for a non-medically-trained person. CDC (talk) 23:05, 25 July 2006 (UTC)

[edit] Notable people who had malaria

I think they might have some. Can we add that to the list. I think Katharine McPhee had Malaria.

No, it's impertinent. And no, we're not going to make a list of notable people who had the common cold, either. —User:Arual 22:10, 17 July 2006 (UTC)

[edit] Additional info

I read the following interesting claims from a pro-market lobby group called the The Campaign for Fighting Diseases. Clearly insecticides and better water management would help if used properly, but I don't know if there's any basis for the other claims about using oral rehydration salts and existing drugs:

Two-thirds of all African children who die under the age of five could be saved by low-cost treatments such as vitamin A supplements, oral rehydration salts and existing combination-therapy drugs against malaria. Better water management and spraying inexpensive insecticides inside dwellings have been proven to reduce malaria significantly.

But basic vaccinations and drugs are still not getting to a majority of people in sub-Saharan Africa and poor nutrition contributes to over half of all deaths associated with infectious diseases in children under five. [3]

I don't know the topic well, nor whether the organisation is notable, so I'll just leave the quote here. --Singkong2005 ^talk 13:57, 20 July 2006 (UTC)

The oral rehydration salts is relevant to gastroenteritis (rather than malaria per se) and if available with a clean water supply would indeed save thousands of deaths. I'm sure nutrition contributes, but well fed "westerners" going on holiday and getting malaria can also die if not then promptly treated. David Ruben ^Talk 15:33, 20 July 2006 (UTC)

[edit] Trojan horse?

This was removed from the article by an anonymous editor, with the comment Two sentences lacked authoritative tone, contained bad sentence structure, and presented dubious facts. They detracted from the article's credibility, so I removed them.:

How it escapes undetected has been a mystery until a recent discovery. The parasite performs a trojan horse in the dead liver cell. In addition to this ability is that it releases cloaking chemicals to prevent detection.

Fair enough. But I'm posting it here in case it has value, and can be improved and referenced. --Singkong2005 ^talk 03:55, 10 August 2006 (UTC)

Marasama 17:46, 11 August 2006 (UTC)The extra reference at the bottom tells how the parasite moves out of the liver undetected and into the blood stream. http://www.livescience.com/humanbiology/060808_sneaky_parasite.html

Yeah, my writing skill on that was lacking, but I thought one of you would perfect it, rather than delete it.

Thanks, CarpD (^_^)

Good - I've reinserted the deleted material with the reference (as a footnote). It probably needs further rewording by someone who understands the material. Thanks CarpD a.k.a Marasama. --Singkong2005 ^talk 03:55, 20 August 2006 (UTC)

[edit] Chronic Infection numbers?

I understand Malaria can become a chronic infection lasting years or even decades. What estimates are there for the total infected population? -- KarlHallowell 02:39, 19 August 2006 (UTC)

[edit] Half a billion?

From the article: "Malaria (Italian bad air; formerly called ague in English) is a tropical disease which causes about half a billion infections and 2 million deaths annually"

sounds to me like Malaria infects half a billiton persons per year which can't be true. -- mkrohn 10:02 25 May 2003 (UTC)

I can't see why not. There are easily enough pepple in areas where malaria is endemic, like India and Africa.- I'll try to check jimfbleak 13:54 25 May 2003 (UTC)

see www.idrc.ca/books/reports/1996/01-07e.html which confirms size of problem. jimfbleak 13:55 25 May 2003 (UTC)

That's a dead link, and the reference in the article is a book (Campbell, Neil A. et al. "Biology" Seventh edition. Menlo Park, CA: Addison Wesley Longman, Inc. 2005), so it's not easily checked. Surely 350-500 million annually can't be right - ten years and you'd have over half the world's population. I guess there's some recurrence, though I thought that happened because the parasite is dormant and then awakens, not because of getting bitten again. Could it be that the 350-500 million is the total number infected at one time, as opposed to new infections annually? The wording is a bit ambiguous. --Singkong2005 ^talk 00:00, 5 September 2006 (UTC)

The figures are from the WHO reports. No one takes the precise numbers too seriously but they are the most reliable figures anyone has. Only tuberculosis is in the same league for deaths per year (~3 million) - this figure is also WHO sourced.

The commonly accepted figure in most articles in most respectable medical journals is 500 000 infections per year. Look in the first paragraph of virtually any scientific paper of the subject. This is usually sourced to WHO, but i confecc i am having trouble finding the original citation. Think of how many cases of infection with the common cold occour each year, it is certainly feasable. Malaria does not produce immune memory, so people can be infected every year, or even twice in a year. There are 3 000 000 000 people in endemic regions, so if every on of them gets infected once every 6 years there's your half a billion easily. Cadmiumcandy 07:21, 13 September 2006 (UTC)

134.226.1.136 21:21, 7 Sep 2004 (UTC)

[edit] Recrudescence and latent infections (relapses)

From my knowledge, very little is really known about latent infections and relapses. Though I believe P. vivax (and maybe P. ovale), and not P. falciparum, is responsible for these infections. This is why I removed "although cases have been reported up to four years after exposure" from the statement about P. falciparum infections.Kurtrik 01:47, 31 October 2006 (UTC)

From the CDC[4]: In P. vivax and P. ovale infections, patients having recovered from the first episode of illness may suffer several additional attacks ("relapses") after months or even years without symptoms. Relapses occur because P. vivax and P. ovale have dormant liver stage parasites ("hypnozoites") that may reactivate. Treatment to reduce the chance of such relapses is available and should follow treatment of the first attack.Kurtrik 02:07, 31 October 2006 (UTC)

I was paraphrasing this paper. TimVickers 03:36, 31 October 2006 (UTC)

From Clinical review: Severe malaria Pre-patent and incubation periods Most nonimmune travelers develop symptoms of falciparum malaria within 1 month of departing from a malaria-endemic area (median 10 days); there have been reports of falciparum malaria presenting up to 4 years later [7]. For nonfalciparum malaria the incubation period is usually longer (median 15–16 days), and both P. vivax and P. ovale malaria may relapse months or years after exposure due to the presence of hypnozoites in the liver. The longest reported incubation period for P. vivax is 30 years [7].

It's generally accepted that falciparum doesn't form hypnozoites, and therefore can never "relapse." What may have happened in this rare 4-years-later case is that the person carried low levels of falciparum in their blood for four years, and it went through a recrudescence. Only vivax and ovale, which form the latent hypnozoites, will result in relapse infections. (I'm getting this from Dickson Despommier's text "Parasitic Diseases," 5th ed.). I would argue that we should maintain the classical information in the wiki article, leaving out the single case of 4-year recrudescence, and emphasising the relapse abilities of vivax and ovale. Kurtrik 15:17, 31 October 2006 (UTC)

OK, done. TimVickers 18:21, 31 October 2006 (UTC)

[edit] Periodicity

I can't get access to that paper you cited. However, here it says "48-50 hours in case of P. vivax, P. ovale, and P. falciparum, but 72 hours in P. malariae" Is the piece on periodicity a typo? TimVickers 05:04, 31 October 2006 (UTC)

The Despommier text says this as well. I will change it back to this, using the RBM as a source.Kurtrik 17:19, 31 October 2006 (UTC)

Thanks, I wish there were fewer organisms, having multiple etiological agents is simply confusing! TimVickers 18:20, 31 October 2006 (UTC)

[edit] Plan of action for FA process

I intend to bring this article to FA quality and take it through the FA process. As part of this we will need to ensure it conforms to WP:LAYOUT and WP:MEDMOS, and uses the highest quality sources specific to the subject area,. Any changes I may make that seem not to improve the article, but just put it in a different format, will probably be due to me trying to re-arrange things to fit these guidelines. TimVickers 05:12, 2 November 2006 (UTC)

[edit] Discussion on merging of Malarial parasite

There is no need for a separate article titled "malarial parasite." Let's move the info to this page.Kurtrik 17:53, 18 November 2006 (UTC)

There is nothing on the "Malaria parasite" page that is not here already. I propose simply replacing the Malaria parasite page with a redirect to "Plasmodium". TimVickers 19:03, 18 November 2006 (UTC)

I concurr - although that's technically a merge into Plasmodium. --Sigma 7 02:38, 19 November 2006 (UTC)

OK, merge done. TimVickers 19:35, 20 November 2006 (UTC)

[edit] Possible copyright violation?

In the Diagnosis section is the following text: "Please refer to the chapters on each parasite for their microscopic appearances. P. falciparum, P. vivax, P. ovale, P. malariae.". Chapters? Either this is taken from someone's book, or the word chapters is being inappropriately used. --Xyzzyplugh 00:21, 18 December 2006 (UTC)

That should read article, thanks. TimVickers 00:23, 18 December 2006 (UTC)

[edit] Experimental "conjugate technology" vaccine

It doesn't help the person who has been bitten, but it will eliminate the parasites from the mosquito.[5] Brian Pearson 06:13, 19 December 2006 (UTC)

[edit] HIV, TB co-infections

Under the "Distrubution and Impact" heading, there are several phrases speaking to co-infections of HIV, TB and malaria:

Although co-infection with HIV and malaria does cause increased mortality, this is less of a problem than with HIV/tuberculosis co-infection, due to the two diseases usually attacking different age-ranges, with malaria being most common in the young and tuberculosis most common in the old.[16] However, in areas of unstable malaria transmission, HIV does contribute to the incidence of severe malaria in adults during malaria outbreaks.[17] There is also a high correlation between HIV and malaria. This correlation has lead to scientific research that suggests that malaria itself is a major contributor to the spread of HIV[18]. This study shows that, "Higher viral load causes more HIV transmission, and malaria causes high HIV viral load."

This section should be reviewed and edited: the first sentence doesn't make sense (for example, TB infects individuals of all ages); there isn't a reference for the info on TB; and if the study is going to be referenced (ref. #18), please use the PMID=17158329 rather than the dogflu.ca link. I hope to revisit this myself soon, but I wanted to mention it on the talk page in case if I don't.Kurtrik 04:05, 15 January 2007 (UTC)

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