History of Malaria - Origin and Early History

Origin and Early History

Human malaria likely originated in Africa and has coevolved along with its hosts, mosquitoes and non-human primates. The first evidence of malaria parasites was found in mosquitoes preserved in amber from the Palaeogene period that are approximately 30 million years old. Malaria may have been a human pathogen for the entire history of the species. Humans may have originally caught Plasmodium falciparum from gorillas. About 10,000 years ago malaria started having a major impact on human survival which coincides with the start of agriculture (Neolithic revolution); a consequence was natural selection for sickle-cell disease, thalassaemias, glucose-6-phosphate dehydrogenase deficiency, ovalocytosis, elliptocytosis and loss of the Gerbich antigen (glycophorin C) and the Duffy antigen on the erythrocytes because such blood disorders confer a selective advantage against malaria infection (balancing selection). The three major types of inherited genetic resistance (sickle-cell disease, thalassaemias, and glucose-6-phosphate dehydrogenase deficiency) were present in the Mediterranean world by the time of the Roman Empire, about 2000 years ago.

References to the unique periodic fevers of malaria are found throughout recorded history. According to legend, the Chinese emperor Huang Di (Yellow Emperor, 2697–2590 BCE) ordered the compilation of a canon of internal medicine. The Chinese Huangdi Neijing (The Inner Canon of the Yellow Emperor) apparently refers to repeated paroxysmal fevers associated with enlarged spleens and a tendency to epidemic occurrence – the earliest written report of malaria.

The term 'miasma' was coined by Hippocrates of Kos who used it to describe dangerous fumes from the ground that are transported by winds and can cause serious illnesses. The name malaria, derived from ‘mal’aria’ (bad air in Medieval Italian). This idea came from the Ancient Romans who thought that this disease came from the horrible fumes from the swamps. The idea that the disease came from the foul gasses released from soil, water and air persisted throughout the nineteenth century.

Malaria was once common in most of Europe and North America, where it is now for all purposes non-existent. The coastal plains of southern Italy, for example, fell from international prominence (the Crusaders going by sea to the Holy Land took ship at Bari) when malaria expanded its reach in the sixteenth century. At roughly the same time, in the coastal marshes of England, mortality from "marsh fever" or "tertian ague" ("the ague" from Latin "febris acuta") was comparable to that in sub-Saharan Africa today. William Shakespeare was born at the start of the especially cold period that climatologists call the "Little Ice Age", yet he was aware enough of the ravages of the disease to mention it in eight of his plays. Throughout history the most critical factors in the spread or eradication of disease have been human behavior (shifting population centers, changing farming methods and the like) and living standards. Precise statistics do not exist because many cases occur in rural areas where people do not have access to hospitals or the means to afford health care. As a consequence, the majority of cases are undocumented. Poverty has been and remains a reason for the disease to remain while it has undergone a decline in other locations. Climate change is likely to affect future trends in malaria transmission, but the severity and geographic distribution of such effects is currently uncertain, though attracting increasing scientific attention.