Malaria as a complication to landmines and war injuries

Malaria poses one of the world's largest health threats, causing acute sickness in 300 million people annually, of whom around one million die. About 40% of the world's population are threatened by malaria and most of the people affected live in the poorest countries. These are also the countries where the incidence of landmine and other war injuries are highest.

It is the Plasmodium parasite that is responsible for causing malaria. There are four different species of this parasite which can infect humans, of which Plasmodium falciparum is the most dangerous. P. falciparum can lead to serious and potentially lethal malaria, but in areas where there is a high incidence of this parasite, humans will gradually develop a certain immunity to it. They become infected without falling ill and are symptom-free carriers of the disease. But if they sustain injuries which need surgical treatment, their immune system will be weakened and they may fall ill with malaria.

While conducting her doctoral research, Tove Heger has examined patients with injuries, mainly landmine victims, in Northwest Cambodia. She discovered that malaria was a serious problem for patients with landmine injuries and that nearly a third of them were afflicted with the disease. Those who fell ill with malaria did not have an increased risk of dying, but the disease led to additional problems such as secondary infections (in wounds) and longer hospitalisation.

The majority of these patients are poor farmers who are particularly vulnerable when it comes to an increase in economic burdens and the loss of income due to an incapacity for work. Attempts were made to prevent this problem by administering early treatment against malaria to all trauma patients shown to be infected with the disease. A large proportion of these patients nevertheless developed symptoms of the disease.