You can get three months’ worth of preventive medicines for free at the headquarters of the Anti-Malaria Campaign on Elvitigala Mawatha, Colombo 5 or at any one of their 20 regional offices but few travellers find their way to such a centre. Many aren’t even aware that they could be at risk of contracting malaria while travelling abroad, says Dr. Sarath Deniyage, the Head of Sri Lanka’s Anti-Malaria Campaign.

In some ways this is good news. People aren’t concerned because the number of cases has been steadily dropping every year and malaria hasn’t claimed a life here in the last three years according to Dr. Deniyage. However, the fight is far from won. Malaria has more than once made a frightening comeback. With the incidence the lowest it’s been in a long time, this is Sri Lanka’s chance to stamp it out altogether.

Malaria epidemics once ravaged the country. Dr. Deniyage explains that between 1935 and 1937 alone, the island suffered a devastating bout with the infection that claimed over 82,000 lives and infected an estimated 1.5 million people. Fast-forward to the turn of the millennium in 2000, where over 200,000 cases of malaria were reported in Sri Lanka.

Since then, there’s been a steady decline, says Dr. Deniyage reeling off the impressive statistics: In 2010 there were 684 indigenous cases and 51 foreign cases. In 2011, the numbers were 124 indigenous cases and 51 foreign cases. So far, 2012 looks to be the best yet with only 17 cases having been reported locally, while 40 travellers have brought the disease back with them.

However, succumbing to overconfidence would be a mistake. We’ve have similar numbers to be proud of before, Dr. Deniyage says, explaining that in 1963 the authorities might have thought they too had malaria beat when there were only 17 cases (7 of which were foreigners) reported only to find that a few decades later the infection was rampant once again as the country experienced another epidemic in 1967 – 1969, then again in 1987 and 1990 – 1992.

Behind the epidemics and lives lost are five protozoan species of the genus Plasmodium. P. falciparum, P. vivax, P. ovale, P. malariae and P. knowelsii are responsible for malaria in human beings and they are all transmitted by the bite of an infected female Anopheles mosquito. According to the campaign, the first two are the most common in Sri Lanka, with P.vivax being the most frequently reported type. However, malaria has so fallen from the public eye that it frequently goes unrecognized even by medical professionals says Dr. Deniyage, explaining that a patient might not receive a correct diagnosis until actually admitted into ICU where all the tests are done as a matter of routine.

Doctors should ask patients complaining of recurrent fever (one of the most common symptoms of malaria) about their travel history, he emphasises. If caught early on, particularly within the first 24 hours malaria is imminently treatable. However, if left untreated, the infection can claim lives.

So far, Sri Lanka has been able to contain malaria by intensifying malaria eradication programmes that spread awareness, offer treatment and focus on destroying the breeding grounds of the Anopheles mosquito. (A particularly effective strategy has been the spraying of homes and gardens with DDT.)

Travellers leaving for countries with a malaria problem should avail themselves of the free medicine and advice the Anti-Malaria Campaign is happy to dole out. Dr. Deniyage would be like to see more travellers screened for malaria at the airport itself where the results of a blood test can be made available within an hour, but urges those who experience any symptoms such as recurrent fever, shaking chills, nausea and muscle pain to seek the advice of a doctor at once.

However, while fewer in number, the indigenous cases just might prove harder to tackle. According to the campaign website (www.malariacampaign.gov.lk) during the long decades of the conflict, Sri Lanka’s malaria map changed. ‘The Northern and Eastern districts which previously had a very low incidence of malaria have shown a sharp increase in malaria incidence recorded particularly during the late ’90s  they note. Today, a majority of indigenous cases come from the North and East, says Dr. Deniyagode, citing locations such as Mullaitivu, Kilinochchi, Mannar and Vavuniya. In response, the campaign has made it a point to screen and treat soldiers and other personnel that move frequently across the country and might be infected. However, re-settled populations who might be living near tanks and irrigation works, as well as construction workers assigned to projects there are equally vulnerable and harder to treat, he said.

While anti-malarial drugs are freely available, there is a need for more vehicles that can be deployed for mobile door to door treatment for patients as well as for programmes to raise awareness among the populace. In the meantime, the campaign recommends  taking  simple precautions such as using mosquito nets, wearing clothes that cover arms and legs when outdoors after dusk, using insect repellent and mosquito coils/vaporizers at night.

Contact the Anti-Malaria Campaign for assistance on their hotline: 011 – 7626626 or visit their offices at No: 555/5 , 3rd Floor, Public Health Building, Elvitigala Mw, Colombo 5.

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