Historical Perspective of Malaria

Malaria has infected humans for over 50,000 years and may have been a human pathogen for the entire history of the species (Joy et al., 2003) Close relatives of the human malaria parasites remains common in Chimpanzees (Escalante et al., 1998). References to the unique periodic fevers of malaria are found throughout record history, beginning in 2700BC in China (Cox, 2002). The term “Malarial” was coined from medieval Italian: Mala aria; meaning bad air. In fact the disease was formerly called ague or marsh fever because it was often associated with swamps and marsh land (Cox, 2002). The first scientific report in the study of malaria was made in 1880 by a French army doctor named Charles Louis Alphonse Leveran. He was working in military hospital of Constantine in Algeria when he first observed parasites inside the red blood cells of people suffering from malaria. He therefore proposed that malaria is caused by this protozoan. 


This discovery was also the first time protozoa were identified as a disease causing agent. For this and later discoveries, he was awarded the 1907 Nobel Prize for physiology and medicine. The protozoan was called Plasmodium by the Italian Scientists Ettore Marchia Fava and Angelo Celi. A year later, a Cuban doctor named Carlos Finlay who was treating patients with yellow fever in Havana, provided strong evidence that mosquitoes were transmitting the disease to and from humans (Tan et al., 2008).

However, it was in 1898 that a British scientist Sir Ronald Ross proved that malaria is transmitted by mosquitoes. He did this by showing that certain mosquito species transmit malaria to birds and isolated malaria parasites from the salivary glands of mosquitoes that had fed on infected birds. For this work Ross received the 1902 Nobel Prize for medicine. The findings of Finlay and Ross were later confirmed by a medical board headed by Walter Reed in 1900, and its recommendations implemented by William C. George in health measures undertaken during construction of the Panama Canal. This public health work saved the lives of thousands of workers and helped develop the methods used in future public-health campaigns against this disease.

The first effective treatment for malaria came from the bark of cinchona tree, which contains quinine. This tree grows on the slopes of the Andes, mainly in Peru. A tincture made of this natural product was used by the inhabitants of Peru to control malaria, and the Jesuits introduced this practice to Europe during the 1640’s, where it was rapidly accepted (Kaufman and Ruveda, 2005). However, it was not until 1820 that the active ingredient, quinine, was extracted from the bark, isolated and named by the French Chemist Pierre Joseph Pelletier and Joseph Bienaime Caventou (Kyle et al., 1974).

In early twentieth century, before antibiotics patients with syphilis were deliberately infected with malaria to create a fever, following the work of Julius Wagner-Jauregg. By accurately controlling the fever with quinine, the effects of both syphilis and malaria could be minimized. Although some patients died from malaria, this was preferable to the almost certain death from syphilis (Raju, 2006).       

Although the blood and mosquito stages of the malaria life cycle were identified in the 19th and early 20th centuries, it was not until the 1980s that the latent liver form of the parasite was observed (Krostoski et al., 1982). The discovery of this latent form finally explained why people could appear to be cured of malaria, but still relapse years after the parasite had disappeared from their blood streams (Meis et al., 1983).

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