By Gift Briton
Several cases of emerging malaria parasites have been reported in different parts of Africa over the last decade with the latest being in the Central region of Ghana.
Scientists warn that emerging malaria parasites could sabotage the 2030 malaria elimination goal, thereby calling on countries to boost active surveillance of new parasitic infections and to implement the World Health Organization’s (WHO) malaria elimination guidelines including conducting mass testing, mass treatment, and mass relapse prevention, if the goal is to be achieved.
In Ghana, a recent research study titled: Molecular speciation of Plasmodium and multiplicity of P. falciparum infection in the Central Region of Ghana found that although over 90% of new malaria transmissions are caused by malaria parasites commonly known to be endemic in the country, there is an emerging parasite that is causing a significant number of new malaria infections.
Plasmodium falciparum, Plasmodium malaria, and Plasmodium ovale were the only malaria parasites known to be responsible for malaria transmissions in Ghana over the years, with Plasmodium falciparum accounting for the most malaria infections in the country, until scientists discovered Plasmodium vivax (P. vivax) as an emerging parasitic infection in the country responsible for some recent malaria cases.
“The Central region of Ghana is one of the country’s top tourist hubs. So, we suspected that there could be importation of a new species of malaria parasite from other parts of the world to this region. Ghana should be worried because if P. vivax becomes endemic in the country, the quest to eliminate malaria will be unsuccessful,” said Dr. Enoch Aninagyei- Infectious Diseases Epidemiologist at the University of Health & Allied Science in Ghana and a lead researcher for the study.
The researchers also discovered a shift in malaria prevalence. The study found that elderly people (over sixty-year-olds) and adolescents are more likely to get malaria infections compared to children below five years and pregnant mothers, which was not the case before.
According to Dr. Aninagyei, the shift in malaria prevalence poses a concern for malaria control and could jeopardize the malaria elimination target because in most cases, the malaria elimination focus has always been on children below five years and pregnant women.
“This should be a wake-up call for Ghana. The country should not despise the presence of P. vivax among her population and should do intensive surveillance and mass testing to know the actual cases in the country,” he urged, adding that Ghana can take lessons from her Tuberculosis (TB) control program which screens individuals presenting with the slightest suspicion of TB and puts positive cases on treatment whether they show symptoms or not.
With the changing malaria transmission landscape, emerging malaria parasites, and the growing resistance to pesticides by mosquitoes, including changes in their biting behavior, Dr. Aninagyei urges countries to re-imagine malaria control strategies by shifting from the commonly used control methods to implementing the WHO guidelines on malaria elimination.
“There should be mass testing and mass treatment across all malaria-endemic regions in Africa. Countries should not wait for individuals to get malaria. They need to do extensive screening to identify cases and treat them accordingly,” Dr. Aninagyei advised.
“Once there is early detection and early treatment of malaria, we will achieve the global elimination of malaria by 2030. Mosquito parasites have become resistant to some of the commonly used control methods such as pesticides and the use of treated nets. I don’t think the solution to eliminating malaria is the use of pesticides or treated nets. The solution should be mass testing and mass treatment.”
Dr. Aninagyei further called on all stakeholders interested in malaria control and elimination to support the efforts to eliminate malaria in Africa through sustainable collaborations by joining forces to influence mass testing, mass screening, and building essential infrastructure.
