Shaina Collazo

May 10th, 2013

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Malaria: How it affects our health and how effective mosquito nets, Chloroquine and insecticides are in preventing it Introduction All over the globe, malaria has proven to be the most significant parasitic illness. With more people dying from malaria today than they were decades ago, malaria poses the biggest health challenge amongst the poorest nations of the world (Guerin, et al., 2002). An estimated 300 million 500 million people are infected with malaria each year and of those 300 million people approximately three million will die, most of them being children living in Africa (Sachs & Malaney, 2002). Malaria is caused by four species of parasitic Plasmodium protist, two of which are responsible for the majority of infections and deaths (Guerin, et al., 2002). The illness is transmitted and people are infected when they are bitten by the Anopheles mosquitos. These mosquitos pick up the parasite and the plasmodium is continuously transferred as the mosquito continues to bit humans. Symptoms of malaria are not unique to the illness and include such things as fevers and other flu like symptoms. And while malaria can be prevented, for most people, especially in Africa, preventative measures often come too late. Considering that malaria is such a serious problem in Africa many attempts have been made to limit the incidence and transmission of it. These attempts include equipping people with mosquito nets, having people take medicines like chloroquine (an affordable compound that works against all four species of the parasitic Plasmodium protist) and spraying insecticides, including pyrethroid insecticides, to reduce the number of mosquitos responsible for the transmission of the parasite. There is evidence to suggest that these methods do help reduce the incidence of malaria (Nevill, et al., 1996). However, evidence suggests that the use of mosquito nets is far more effective than the use of medicines like chloroquine or pyrethroid insecticides (Nevill et al., 1988). It seems that with time, the plasmodium have been slowly building up 1

Shaina Collazo

May 10th, 2013

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resistance to chloroquine (White, 1998). There is also evidence to suggest that Anopheles mosquitos are also building up resitance to pyrethroid insecticides (Ranson et al., 2011). Resistance to such substances can prove to cause severe consequences as it can lead to an increase in the number of new malaria cases and ultimately the number of deaths (White, 1998). This subject is important to study because it is one of the most infectous illness around and is responsible for the deaths of millions of people. Aprroxiatmatelly 2,000 people die everyday from malaria (Sachs & Malaney, 2002) and until a proper method to prevent the illness is discovered that number will continue to rise. A proper method to prevent malaria or a cure can save millions of live. I had a total of three different hypotheses based on three different experiments and data sets. For the first data set, the null hypothesis was: the use of mosquito nets did not impact the incidence of malaria and the alternative hypothesis was: the use of mosquito nets helped reduce the incidence of malaria. For the second data set, the null hypothesis was: the use of Chloroquine had no impact on the incidence of malaria and the alternative hypothesis was: the use of Chloroquine helped reduce the incidence of malaria. For the final data set, the null hypothesis was: the number of weeks pyrethroid insecticides were used had no impact on how many mosquitos died in the experiment and the alternative hypothesis was: the number of weeks pyrethroid insecticides were used did impact how many mosquitos died in the experiment.

Shaina Collazo Results

May 10th, 2013

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In the first data set, the alternative hypothesis was supported and the use of mosquito nets helped reduce the incidence of malaria. The average amount of new malaria cases in group two, those who were given mosquito nets and told how to use them, was nearly half that of group one ,those were given no treatment at all. (Figure 1)
Average amount of New Malaria Cases per 100 people 25 20 15 10 5 0 Group I Groups given treatments Group II

Figure 1 the average rate of new malaria cases per 100 people between two groups, one group having received no treatment for one year (Group 1) and the other group having been given enough mosquito nets and instructed how to use them in order to prevent infection (Group 2). Error bars represent one standard deviation. A control (average amount of new malaria cases per 100 people who were given no treatment) was used for comparison. An independent t- test comparing the average amount of new malaria cases per 100 people found a statistical difference between both the two groups (t(28) = +5.27, P < 0.0001). Group 1, the group that had no treatment, had a much higher average amount of new malaria cases per 100 people (20.067) than that of group 2, those who were given mosquito nets and were instructed how to use the, (10.867). For the second data set, the alternative hypothesis was not supported and the null hypothesis was accepted. The use of Chloroquine had no impact on the incidence of Malaria. 3

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The average amount of new malaria cases in group three, those who were given chloroquine, was nearly the same as group 1, those were given no treatment at all. (Figure 2)
25 20 15 10 5 0 Group I Groups given treatments Group III

Figure 2 the average rate of new malaria cases per 100 people between two groups of people, one group having received no treatment for one year (Group 1) and the other group having been given the prophylactic drug chloroquine to prevent infection (Group 3). Error bars represent one standard deviation. A control (average amount of new malaria cases per 100 people who were given no treatment) was used for comparison. An independent t- test comparing the average amount of new malaria cases per 100 people did not find statistical difference between both the two groups (t(28) = +1.57, P = 0.063824). Group 1, the group that had no treatment, had an average amount of new malaria cases per 100 people (20.067) relatively close to that of group 3, those who were given chloroquine (17.067). For the final data set, the alternative hypothesis was supported. The more weeks the pyrethroid insecticides were used, fewer and fewer mosquitos were dying in the experiment. (Figure 3)

Average amount of New Malara Cases per 00 people

Shaina Collazo
100 80 60 40 20 0 0 2

May 10th, 2013

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Number of Mosquitos killed

Number of weeks used pyrethroid insecticides

10 12 y = -8.3594x + 106.65 R = 0.9783

Figure 3 the number of mosquitos that died each week after being exposed to pyrethroid insecticides A linear correlation and regression t- test determined that there is a strong negative relationship between the number of weeks the pyrethroid insecticides were used and how many mosquitos died (t(10) = -21.24, P <0.0001). The R2 value is 0.9783 and the equation was Y= -8.3594x +106.65. Discussion Overall the alternative hypothesis was supported for the first data set and the last data set, while it was not supported in the second data set. The use of mosquito nets had a significant impact on the average amount of new malaria cases per 100 people. This supports evidence that suggests that the use of mosquito nets effectively reduces the incidence of malaria and the number of people who die from it (Nevill, et al., 1996). On the other hand, the use of chloroquine did not have an impact on the average amount of new malaria cases per 100 people. This could be due to the plasmodium becoming resistant to chloroquine. Evidence from other studies suggest that the plasmodium protist responsible for malaria is becoming resistant to chloroquine and therefore making it less effective in preventing malaria and a new drug being used in the most severest cases in Africa (White, 1998). If the plasmodium that was responsible 5

Shaina Collazo

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for malaria in that particular area had become resistant to chloroquione, then it would not be effective in reducing malaria. The data supports this suggestion as the average amount of new malaria cases per 100 people that were given chloroquine was just three cases less than those who were given no treatment at all. The two groups were very close in average. However studies suggest that chloroquine is not completely ineffective in preventing malaria and this is why it is still used. Resistance to chloroquine has not spread all over the globe and studies show that even though there is some resistance to chloroquine, it is more effective in preventing malaria than other drugs like it (White, 1998). The difference in effectiveness of mosquito nets and chloroquine supports other studies that suggested that mosquito nets were more effective in reducing malaria than substances like chloroquine and insecticides. The use of mosquito nets reduced the number of new malaria cases to nearly half that of the group that received no treatment while chloroquine only reduced the new malaria cases by three cases. In terms of the final data set, the results support the alternative hypothesis that the number of weeks pyrethroid insecticides were used did impact how many mosquitos died in the experiment. As the weeks continued to pass, fewer and fewer mosquitos were dying in the experiment. It seems that the mosquitos were indeed becoming resistant to the pyrethroid insecticides. This supports other studies that suggested that mosquitos responsible for the transmission of malaria were building up resistance to the pyrethroid insecticides (Ranson et al., 2011).

Shaina Collazo

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References Guerin, P. J., Olliaro, F. N., Druilhe, P., Laxminarayan, R., Binka, F., Kilama, W. L., et al. (2002). Malaria: current status of control, diagnosis, treatment and a proposed agenda for research and development. The Lancet, 564-573. Nevill, C. G., Some, E. S., Mung'ala, V. O., Mutemi, W., New, L., Marsh, K., et al. (1996). Insecticide- treated bednets reduct mortality and sever morbidity from malaria among children n the Kenyan coast. Tropical Medicine and International Health, 139 - 146. Nevill, C. G., Watkins, W. M., Carter, J. V., & Munafu, C. G. (1988). Comparison of mosquito nets, proguanil hydrochloride, and placebo to prevent malaria. British Medical Journal, 401 - 403. Ranson, H., N'Guessan, R., Lines, J., Moiroux, N., Nkuni, Z., & Corbel, V. (2011). Pyrethroid resistance in African Anopheline mosquitos: what are the implications for malara control? Trends in Parasitology, 91 - 98. Sachs, J., & Malaney, P. (2002). The economic and social burden of malaria. Nature, 680-685. White, N. J. (1998). Drug Resistance in malaria. The British Council, 703 - 715.