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101-469: Lake Hula and the marshland surrounding it were a breeding ground for mosquitoes carrying malaria and thus were drained in the 1950s. A small section of the valley was later reflooded in an attempt to revive a nearly extinct ecosystem . An estimated 500 million migrating birds now pass through the Hula Valley every year. Lake Hula was historically referred to by different names. In the 1st century CE,

202-575: A blood meal from a previously Plasmodium infected person or animal. Parasites are then typically introduced by the bite of an infected Anopheles mosquito. Some of these inoculated parasites, called " sporozoites ", probably remain in the skin, but others travel in the bloodstream to the liver , where they invade hepatocytes . They grow and divide in the liver for 2–10 days, with each infected hepatocyte eventually harboring up to 40,000 parasites. The infected hepatocytes break down, releasing these invasive Plasmodium cells, called " merozoites ", into

303-462: A child under five died of malaria in 2021, and "many of these deaths are preventable and treatable". Malaria is commonly associated with poverty and has a significant negative effect on economic development. In Africa, it is estimated to result in losses of US$ 12 billion a year due to increased healthcare costs, lost ability to work, and adverse effects on tourism. The term malaria originates from Medieval Italian : mala aria 'bad air',

404-683: A class of insecticides with low toxicity . They are most effective when used from dusk to dawn. It is recommended to hang a large "bed net" above the center of a bed and either tuck the edges under the mattress or make sure it is large enough such that it touches the ground. ITNs are beneficial towards pregnancy outcomes in malaria-endemic regions in Africa but more data is needed in Asia and Latin America. Malaria in Palestine Malaria

505-414: A consistent supply of microscopy slides and stains. In places where microscopy is unavailable, malaria is diagnosed with RDTs, rapid antigen tests that detect parasite proteins in a fingerstick blood sample. A variety of RDTs are commercially available, targeting the parasite proteins histidine rich protein 2 (HRP2, detects P. falciparum only), lactate dehydrogenase , or aldolase . The HRP2 test

606-615: A delegation to Mandatory Palestine. (Figure 4) The delegation gave international recognition to the importance of anti-malarial activity conducted in the country. Kligler lectured on the war against malaria in Mandatory Palestine at the first international malaria conference held in Rome in October 1925; in the lecture he described the main effort is directed towards destruction of breeding places of mosquitoes. In 1927, he founded

707-472: A greater likelihood of complications and death. Malaria infection affects the immune responses following vaccination for various diseases. For example, malaria suppresses immune responses to polysaccharide vaccines. A potential solution is to give curative treatment before vaccination in areas where malaria is present. Due to the non-specific nature of malaria symptoms, diagnosis is typically suspected based on symptoms and travel history, then confirmed with

808-456: A laboratory test showing hemoglobin levels below 8 grams per deciliter of blood. In areas of the world with little to no malaria, the WHO recommends only testing people with possible exposure to malaria (typically travel to a malaria-endemic area) and unexplained fever. In sub-Saharan Africa, testing is low, with only about one in four (28%) of children with a fever receiving medical advice or

909-488: A laboratory test to detect the presence of the parasite in the blood (parasitological test). In areas where malaria is common, the World Health Organization (WHO) recommends clinicians suspect malaria in any person who reports having fevers, or who has a current temperature above 37.5 °C without any other obvious cause. Malaria should be suspected in children with signs of anemia : pale palms or

1010-534: A large amount of sweat on the surface of the skin. Due to the high levels of lactic acid released from the human body, it has been hypothesized to represent a specific human host-recognition cue for anthropophilic (attracted to humans) mosquitoes. Pungent foot odor Most studies use human odors as stimuli to attract host seeking mosquitoes and have reported a strong and significant attractive effect. The studies have found human odor samples very effective in attracting mosquitoes. Foot odors have been demonstrated to have

1111-404: A large-scale effort was undertaken by Zionist settlers to drain the swamps, clear dense vegetation, and implement public health measures to defend against and suppress the mosquito population, transforming the previously uninhabitable areas into viable land for agriculture and settlement and eventually leading to the complete eradication of malaria in the region by the 1960s. Before 1918, malaria

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1212-636: A less pronounced and almost continuous fever. Symptoms typically begin 10–15 days after the initial mosquito bite, but can occur as late as several months after infection with some P. vivax strains. Travellers taking preventative malaria medications may develop symptoms once they stop taking the drugs. Severe malaria is usually caused by P. falciparum (often referred to as falciparum malaria). Symptoms of falciparum malaria arise 9–30 days after infection. Individuals with cerebral malaria frequently exhibit neurological symptoms, including abnormal posturing , nystagmus , conjugate gaze palsy (failure of

1313-435: A non-invasive way to detect malarial infections. In addition, these volatile compounds were heavily detected by mosquito antennae as an attractant, making the children more vulnerable to the bite of the mosquitos. Fatty acids Fatty acids have been identified as an attractive compound for mosquitoes, they are typically found in volatile emissions from the skin. These fatty acids that produce body odor profiles originate from

1414-564: A part of miasma theory ; the disease was formerly called ague or marsh fever due to its association with swamps and marshland. The term appeared in English at least as early as 1768. Malaria was once common in most of Europe and North America, where it is no longer endemic, though imported cases do occur. The scientific study of malaria is called malariology. Adults with malaria tend to experience chills and fever—classically in periodic intense bouts lasting around six hours, followed by

1515-530: A period of sweating and fever relief—as well as headache, fatigue, abdominal discomfort, and muscle pain . Children tend to have more general symptoms: fever, cough, vomiting, and diarrhea. Initial manifestations of the disease—common to all malaria species—are similar to flu-like symptoms , and can resemble other conditions such as sepsis , gastroenteritis , and viral diseases . The presentation may include headache , fever , shivering , joint pain , vomiting , hemolytic anemia , jaundice , hemoglobin in

1616-575: A postdoctoral scholar at the University of California, Berkeley studying the structural basis of membrane manipulation and cell-cell fusion by bacterial pathogens, discusses studies that determine how odor profiles can be used to diagnose the disease. Within the study, samples of volatile compounds from around 400 children within schools in Western Kenya were collected - to identify asymptomatic infections. These biomarkers have been established as

1717-635: A rapid diagnostic test in 2021. There was a 10-percentage point gap in testing between the richest and the poorest children (33% vs 23%). Additionally, a greater proportion of children in Eastern and Southern Africa (36%) were tested than in West and Central Africa (21%). According to UNICEF, 61% of children with a fever were taken for advice or treatment from a health facility or provider in 2021. Disparities are also observed by wealth, with an 18 percentage point difference in care-seeking behaviour between children in

1818-466: A short time, and a "thin film" of blood, allowing them to clearly see individual parasites and identify the infecting Plasmodium species. Under typical field laboratory conditions, a microscopist can detect parasites when there are at least 100 parasites per microliter of blood, which is around the lower range of symptomatic infection. Microscopic diagnosis is relatively resource intensive, requiring trained personnel, specific equipment, electricity, and

1919-595: A small proportion of public expenditure on health. In contrast, a similar programme in Tanzania would cost an estimated one-fifth of the public health budget. In 2021, the World Health Organization confirmed that China has eliminated malaria. In 2023, the World Health Organization confirmed that Azerbaijan , Tajikistan , and Belize have eliminated malaria. In areas where malaria is common, children under five years old often have anaemia , which

2020-518: A way past the net. Insecticide-treated nets (ITNs) are estimated to be twice as effective as untreated nets and offer greater than 70% protection compared with no net. Between 2000 and 2008, the use of ITNs saved the lives of an estimated 250,000 infants in Sub-Saharan Africa. According to UNICEF, only 36% of households had sufficient ITNs for all household members in 2019. In 2000, 1.7 million (1.8%) African children living in areas of

2121-479: Is a feature of blackwater fever , where haemoglobin from lysed red blood cells leaks into the urine. Infection with P. falciparum may result in cerebral malaria, a form of severe malaria that involves encephalopathy . It is associated with retinal whitening, which may be a useful clinical sign in distinguishing malaria from other causes of fever. An enlarged spleen , enlarged liver or both of these , severe headache, low blood sugar , and haemoglobin in

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2222-518: Is associated with potentially life-threatening conditions about as often as with a diagnosis of P. falciparum infection. P. vivax proportionally is more common outside Africa. Some cases have been documented of human infections with several species of Plasmodium from higher apes , but except for P. knowlesi —a zoonotic species that causes malaria in macaques —these are mostly of limited public health importance. The Anopheles mosquitos initially get infected by Plasmodium by taking

2323-446: Is caused by six Plasmodium species: P. falciparum , P. malariae , P. ovale curtisi , P. ovale wallikeri , P. vivax and P. knowlesi . Among those infected, P. falciparum is the most common species identified (~75%) followed by P. vivax (~20%). Although P. falciparum traditionally accounts for the majority of deaths, recent evidence suggests that P. vivax malaria

2424-465: Is deemed severe when any of the following criteria are present, otherwise it is considered uncomplicated. Cerebral malaria is defined as a severe P. falciparum -malaria presenting with neurological symptoms, including coma (with a Glasgow coma scale less than 11, or a Blantyre coma scale less than 3), or with a coma that lasts longer than 30 minutes after a seizure. Methods used to prevent malaria include medications, mosquito elimination and

2525-531: Is insufficient evidence that mosquito repellents can prevent malaria infection. Insecticide-treated nets (ITNs) and indoor residual spraying (IRS) are effective, have been commonly used to prevent malaria, and their use has contributed significantly to the decrease in malaria in the 21st century. ITNs and IRS may not be sufficient to eliminate the disease, as these interventions depend on how many people use nets, how many gaps in insecticide there are (low coverage areas), if people are not protected when outside of

2626-451: Is not available. In areas where the disease is common, malaria should be confirmed if possible before treatment is started due to concerns of increasing drug resistance . Resistance among the parasites has developed to several antimalarial medications; for example, chloroquine -resistant P. falciparum has spread to most malarial areas, and resistance to artemisinin has become a problem in some parts of Southeast Asia . The disease

2727-400: Is relatively invisible to immune surveillance. However, circulating infected blood cells are destroyed in the spleen . To avoid this fate, the P. falciparum parasite displays adhesive proteins on the surface of the infected blood cells, causing the blood cells to stick to the walls of small blood vessels, thereby sequestering the parasite from passage through the general circulation and

2828-449: Is sometimes due to malaria. Giving children with anaemia in these areas preventive antimalarial medication improves red blood cell levels slightly but does not affect the risk of death or need for hospitalisation. Vector control refers to methods used to decrease malaria by reducing the levels of transmission by mosquitoes. For individual protection, the most effective insect repellents are based on DEET or picaridin . However, there

2929-408: Is spread exclusively through bites of infected female Anopheles mosquitoes. The mosquito bite introduces the parasites from the mosquito's saliva into a person's blood. The parasites travel to the liver , where they mature and reproduce. Five species of Plasmodium commonly infect humans. The three species associated with more severe cases are P. falciparum (which is responsible for

3030-770: Is the stopover point for tens of thousands of cranes migrating from Finland to Ethiopia every winter. In Israel, farmers set out food for them to keep them from damaging crops near the lake. Some 24,000 ha of the northern Hula Valley, including the nature reserve, has been recognised as an Important Bird Area (IBA) by BirdLife International because it supports populations of many species of birds, especially raptors and waterbirds , either as breeding residents, winter visitors or passage migrants . These include marbled teals , pygmy cormorants , sociable lapwings , European honey buzzards , greater and lesser spotted eagles , eastern imperial eagles , Levant sparrowhawks , lesser kestrels and Dead Sea sparrows . In November 2011

3131-425: Is typical) to several years. After a period of dormancy, they reactivate and produce merozoites. Hypnozoites are responsible for long incubation and late relapses in P. vivax infections, although their existence in P. ovale is uncertain. The parasite is relatively protected from attack by the body's immune system because for most of its human life cycle it resides within the liver and blood cells and

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3232-413: Is typically attributed to treatment failure. People may develop some immunity when exposed to frequent infections. Malaria infection develops via two phases: one that involves the liver (exoerythrocytic phase), and one that involves red blood cells, or erythrocytes (erythrocytic phase). When an infected mosquito pierces a person's skin to take a blood meal, sporozoites in the mosquito's saliva enter

3333-765: Is widely used in Africa, where P. falciparum predominates. However, since HRP2 persists in the blood for up to five weeks after an infection is treated, an HRP2 test sometimes cannot distinguish whether someone currently has malaria or previously had it. Additionally, some P. falciparum parasites in the Amazon region lack the HRP2 gene, complicating detection. RDTs are fast and easily deployed to places without full diagnostic laboratories. However they give considerably less information than microscopy, and sometimes vary in quality from producer to producer and lot to lot. Serological tests to detect antibodies against Plasmodium from

3434-512: Is widespread in the tropical and subtropical regions that exist in a broad band around the equator . This includes much of sub-Saharan Africa , Asia , and Latin America . In 2022, some 249 million cases of malaria worldwide resulted in an estimated 608,000 deaths, with 80 percent being five years old or less. Around 95% of the cases and deaths occurred in sub-Saharan Africa. Rates of disease decreased from 2010 to 2014, but increased from 2015 to 2021. According to UNICEF, nearly every minute,

3535-554: The Akkadian language c.  1360 BCE. The Waters of Merom has sometimes been used in scientific literature, although that term refers specifically to springs on the western side of the valley. Prior to its drainage in the early 1950s, Lake Hula was 5.3 km (3.3 mi) long and 4.4 km (2.7 mi) wide, extending over 12-14 square kilometers. It was about 1.5 m (4 ft 11 in) deep in summer and 3 m (9.8 ft) deep in winter. The marsh-like lake

3636-622: The Aliyah , Kligler gathered information about the health issues in the country and acquired experience in the field by joining a delegation for the Study of Yellow Fever in South America. Kligler prepared a malaria eradication program that was sent to several organizations and public figures, including Justice Louis Brandeis, who visited the country in 1919 and was shocked by the morbidity of malaria. After failing to convince Chaim Weizmann and

3737-657: The Hula painted frog , classified as extinct since 1996 by the IUCN as a result of the marsh drainage, reappeared to park patrollers in HaHula. The reappearance was confirmed by the Israel Nature and Parks Authority . Since the discovery of the first specimen at least ten more have been found, all in the same area. The IUCN has accordingly reclassified the species as critically endangered . Archaeological findings in 2009 show that

3838-464: The Sea of Galilee . The Hula Valley has a Mediterranean climate of hot dry summers and cool rainy winters, although its enclosure within two mountain ranges leads to more extreme seasonal and daily temperature fluctuations than in coastal areas. Annual rainfall varies greatly between different parts of the valley and ranges from about 400 millimeters in the south of the valley, to up to 800 millimeters in

3939-649: The Waters of Merom , a lake in the valley, as the site of a victory of Joshua over the Canaanites . Throughout the Hellenistic , Roman , Byzantine and early Arab periods (fourth century BCE to eighth centuries CE) rural settlement in the Hula Valley was uninterrupted. During the Seleucid Empire , the town Seleucia Samulias was founded on the lake shore. Traditional crops were rice (as early as

4040-411: The bone marrow for 11 days, then return to the blood circulation to await uptake by the bite of another mosquito. Once inside a mosquito, the gametocytes undergo sexual reproduction, and eventually form daughter sporozoites that migrate to the mosquito's salivary glands to be injected into a new host when the mosquito bites. The liver infection causes no symptoms; all symptoms of malaria result from

4141-425: The hominids who inhabited the area exploited Lake Hula fish. Analysis of the fish remains recovered from the archaeological site of Gesher Benot Ya‘aqov (GBY) has shown that they exploited a wide range of fish including catfish, tilapia and carp. Some of the carp were over a meter long. Tools to light fires and crack nuts were also discovered at the site. In December 2007 Israel issued a set of three stamps featuring

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4242-637: The papyrus with which they built their homes. John MacGregor , a Victorian adventurer, was captured with his boat, the "Rob Roy", by dark-skinned Bedouin living in the Hula marshes. He was responsible for the first modern maps of the area. Mortality rates were very high due to the spread of malaria . In 1882, a traveler wrote that the region was "among the finest hunting grounds in Syria," home to "panthers, leopards, bears, wild boars, wolves, foxes, jackals, hyenas, gazelles and otters." During World War II, officers of

4343-491: The polymerase chain reaction to detect the parasite's DNA have been developed, but they are not widely used in areas where malaria is common, due to their cost and complexity. The risk of disease can be reduced by preventing mosquito bites through the use of mosquito nets and insect repellents or with mosquito-control measures such as spraying insecticides and draining standing water . Several medications are available to prevent malaria for travellers in areas where

4444-605: The "Malaria Research Station" of the Hebrew University in Rosh Pina , where pioneering fieldwork was carried out relating to the eradication of malaria. Two years later, he appointed Dr. Gideon Mer as the station manager and together they published a series of articles on malaria. In a 1932 report, Kligler stated the disease was largely controlled in Jewish and neighboring Arab villages. In non-Jewish regions, malaria

4545-756: The British Army wrote about hunting birds there. In 1908, the Ottoman government granted a concession to drain the marsh to a French firm, which sold it to Lebanese businessmen. In 1933, during the British Mandate , the Zionist Palestine Land Development Company was awarded this concession by the Mandatory government and drew up plans to drain and irrigate the valley which brought scientific expeditions to

4646-584: The Hellenistic period), cotton and sugar cane (brought by the Arabs following their conquest in 636), sorghum and maize (brought after the discovery of the Americas). Water buffalo were introduced in the eighth century supplying milk and serving as beasts of burden. In the 19th century, the valley, mainly marshy ground and a shallow lake, was inhabited by Ghawaraneh Bedouin who wove matting from

4747-491: The Hula nature reserve. Malaria Malaria is a mosquito-borne infectious disease that affects vertebrates and Anopheles mosquitoes. Human malaria causes symptoms that typically include fever , fatigue , vomiting , and headaches . In severe cases, it can cause jaundice , seizures , coma , or death . Symptoms usually begin 10 to 15 days after being bitten by an infected Anopheles mosquito . If not properly treated, people may have recurrences of

4848-643: The Jewish-Roman historian Flavius Josephus termed it Semechonitis ( Greek : Σημεχωνίτις , romanized :  Sēmekhonítis ), John Lightfoot writing it as Samochonitis , while in the Talmud it is called the Sea/Lake of Siwkhi ([יַמָּהּ שֶׁל סִיבְכִי] Error: {{Lang}}: invalid parameter: |3= ( help ) ). Both names are identified with the place-name Šamḫuna found in the Amarna letters written in

4949-511: The Zionist executives of the need to invest in the eradication of malaria, Brandeis privately financed $ 10,000 for an experimental malaria elimination project. This project was directed by Kliger and run through Hadassah Medical Centre . In the Galilee and around Lake Kinnereth ( Sea of Galilee ), malaria had decimated the Jewish settlements, with the incidence rate "at better than 95 percent of

5050-405: The absence of Duffy antigens on red blood cells. The impact of sickle cell trait on malaria immunity illustrates some evolutionary trade-offs that have occurred because of endemic malaria. Sickle cell trait causes a change in the haemoglobin molecule in the blood. Normally, red blood cells have a very flexible, biconcave shape that allows them to move through narrow capillaries ; however, when

5151-469: The appropriate measures, taking into account their efficiency and cost. His work demonstrated that drainage of the swamps alone would have had little effect on the malaria, because the mosquitoes breed in small pools of water, which even the most elaborate system of drainage would not have reached. It was subsequently pointed out that at least half of the malaria could be ascribed simply to human carelessness and neglect. This resulted in such an improvement to

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5252-403: The area. A visitor to the area in the 1930s reported that the villages in the area harvested the papyrus for weaving. They used two distinct styles of loom: one for fine mats for interior use, and a second producing longer, coarser mats which were used for constructing huts and shelters. The first modern Jewish settlement in the Hula Valley, Yesud HaMa'ala on the western shore of the lake,

5353-418: The blood have been developed, but are not used for malaria diagnosis due to their relatively poor sensitivity and specificity. Highly sensitive nucleic acid amplification tests have been developed, but are not used clinically due to their relatively high cost, and poor specificity for active infections. Malaria is classified into either "severe" or "uncomplicated" by the World Health Organization (WHO). It

5454-430: The bloodstream and migrate to the liver where they infect hepatocytes, multiplying asexually and asymptomatically for a period of 8–30 days. After a potential dormant period in the liver, these organisms differentiate to yield thousands of merozoites, which, following rupture of their host cells, escape into the blood and infect red blood cells to begin the erythrocytic stage of the life cycle. The parasite escapes from

5555-540: The bloodstream. In the blood, the merozoites rapidly invade individual red blood cells , replicating over 24–72 hours to form 16–32 new merozoites. The infected red blood cell lyses, and the new merozoites infect new red blood cells, resulting in a cycle that continuously amplifies the number of parasites in an infected person. Over rounds of this infection cycle, a small portion of parasites do not replicate, but instead develop into early sexual stage parasites called male and female " gametocytes ". These gametocytes develop in

5656-408: The brain, they contribute to coma . In the placenta they contribute to low birthweight and preterm labor, and increase the risk of abortion and stillbirth. The destruction of red blood cells during infection often results in anemia, exacerbated by reduced production of new red blood cells during infection. Only female mosquitoes feed on blood; male mosquitoes feed on plant nectar and do not transmit

5757-434: The cause, recurrence can be classified as either recrudescence , relapse , or reinfection. Recrudescence is when symptoms return after a symptom-free period due to failure to remove blood-stage parasites by adequate treatment. Relapse is when symptoms reappear after the parasites have been eliminated from the blood but have persisted as dormant hypnozoites in liver cells. Relapse commonly occurs between 8 and 24 weeks after

5858-521: The development of respiratory distress , which occurs in up to 25% of adults and 40% of children with severe P. falciparum malaria. Possible causes include respiratory compensation of metabolic acidosis , noncardiogenic pulmonary oedema , concomitant pneumonia , and severe anaemia . Although rare in young children with severe malaria, acute respiratory distress syndrome occurs in 5–25% of adults and up to 29% of pregnant women. Coinfection of HIV with malaria increases mortality. Kidney failure

5959-509: The disease in the long run, but the initial costs required are out of reach of many of the world's poorest people. There is a wide difference in the costs of control (i.e. maintenance of low endemicity) and elimination programs between countries. For example, in China—whose government in 2010 announced a strategy to pursue malaria elimination in the Chinese provinces —the required investment is

6060-578: The disease is common. Occasional doses of the combination medication sulfadoxine/pyrimethamine are recommended in infants and after the first trimester of pregnancy in areas with high rates of malaria. As of 2023, two malaria vaccines have been endorsed by the World Health Organization . The recommended treatment for malaria is a combination of antimalarial medications that includes artemisinin . The second medication may be either mefloquine , lumefantrine , or sulfadoxine/pyrimethamine. Quinine , along with doxycycline , may be used if artemisinin

6161-475: The disease months later. In those who have recently survived an infection, reinfection usually causes milder symptoms. This partial resistance disappears over months to years if the person has no continuing exposure to malaria. The mosquito vector is itself harmed by Plasmodium infections, causing reduced lifespan. Human malaria is caused by single-celled microorganisms of the Plasmodium group. It

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6262-462: The disease. Females of the mosquito genus Anopheles prefer to feed at night. They usually start searching for a meal at dusk, and continue through the night until they succeed. However, in Africa, due to the extensive use of bed nets, they began to bite earlier, before bed-net time. Malaria parasites can also be transmitted by blood transfusions , although this is rare. Symptoms of malaria can recur after varying symptom-free periods. Depending upon

6363-592: The east and the Upper Galilee 's Naftali Mountains to the west rise to 400 to 900 meters above sea level . Basalt hills of about 200 meters above sea level along the southern side of the valley intercept the Jordan River , and are commonly referred to as the basalt "plug", the Korazim block, or Korazim Plateau (actually a temporary geologic base level ), as they restrict water drainage downstream into

6464-494: The eyes to turn together in the same direction), opisthotonus , seizures , or coma . Diagnosis based on skin odor profiles Humans emanate a large range of smells. Studies have been conducted on how to detect human malaria infections through volatile compounds from the skin - suggesting that volatile biomarkers may be a reliable source for the detection of infection, including those asymptomatic. Using skin body odor profiles can be efficient in diagnosing global populations, and

6565-442: The frequency with which malaria parasites complete their life cycle in the cell. Individuals who are homozygous (with two copies of the abnormal haemoglobin beta allele ) have sickle-cell anaemia , while those who are heterozygous (with one abnormal allele and one normal allele) experience resistance to malaria without severe anaemia. Although the shorter life expectancy for those with the homozygous condition would tend to disfavour

6666-471: The growth and development of these communities. Jews settled in the less inhabited coasts and valleys, which had high rates of malaria and were more easily bought . Israel Jacob Kligler was a microbiologist, a Zionist, and a key contributor to the eradication of malaria in Israel. Malaria was a major factor in morbidity and death in the country, and had important repercussions for Jewish settlement. Before

6767-399: The highest attractiveness to anthropophilic mosquitoes. Some of these studies have included traps that had been baited with nylon socks previously worn by human participants and were deemed efficient in catching adult mosquitos. Foot odors have high numbers of volatile compounds, which in turn elicit an olfactory response from mosquitoes. Malaria has several serious complications , including

6868-429: The home, and an increase in mosquitoes that are resistant to insecticides. Modifications to people's houses to prevent mosquito exposure may be an important long term prevention measure. Mosquito nets help keep mosquitoes away from people and reduce infection rates and transmission of malaria. Nets are not a perfect barrier and are often treated with an insecticide designed to kill the mosquito before it has time to find

6969-612: The incidence rate had dropped to zero in most places in the upper Galilee and Jezreel Valley . Between 1922 and 1926, there was almost complete elimination of Anopheles and malaria in those areas. The achievements of Kligler and his staff in combating malaria were brought to the attention of the Health Organization , an agency of the League of Nations , the predecessor of the World Health Organization , which in May 1925 sent

7070-423: The infection of red blood cells. Symptoms develop once there are more than around 100,000 parasites per milliliter of blood. Many of the symptoms associated with severe malaria are caused by the tendency of P. falciparum to bind to blood vessel walls, resulting in damage to the affected vessels and surrounding tissue. Parasites sequestered in the blood vessels of the lung contribute to respiratory failure . In

7171-502: The initial symptoms and is often seen in P. vivax and P. ovale infections. P. vivax malaria cases in temperate areas often involve overwintering by hypnozoites, with relapses beginning the year after the mosquito bite. Reinfection means that parasites were eliminated from the entire body but new parasites were then introduced. Reinfection cannot readily be distinguished from relapse and recrudescence, although recurrence of infection within two weeks of treatment ending

7272-718: The large commercial centre of Damascus with the Eastern Mediterranean coast and Egypt . During the Bronze Age , the cities of Hazor and Laish were built at key locations on this route approximately 4,000 years ago. At some point, the area came under the control of the Israelites , until it was captured by the Neo-Assyrian Empire 's armies under Tiglath-Pileser III (reigned 745–727 BC) and its inhabitants were driven away. The Bible records

7373-634: The liver undetected by wrapping itself in the cell membrane of the infected host liver cell. Within the red blood cells, the parasites multiply further, again asexually, periodically breaking out of their host cells to invade fresh red blood cells. Several such amplification cycles occur. Thus, classical descriptions of waves of fever arise from simultaneous waves of merozoites escaping and infecting red blood cells. Some P. vivax sporozoites do not immediately develop into exoerythrocytic-phase merozoites, but instead, produce hypnozoites that remain dormant for periods ranging from several months (7–10 months

7474-477: The marsh. G. Schumacher , visiting the region in 1883, described the Hula valley in the following terms: Ard el Huleh . The whole country of the marshes of the Huleh Lake, a swampy territory thickly overgrown with papyrus. It abounds in snipe , wild ducks, francolins and many other kinds of birds, and is consequently much resorted to by the hunter, but as carefully avoided by the inhabitants on account of

7575-431: The metabolism of glycerol, lactic acid, amino acids, and lipids - through the action of bacteria found within the skin. They create a “chemical signature” for the mosquitoes to locate a potential host, humans in particular. Lactic acid Lactic acid, a naturally produced levorotatory isomer, has been titled an attractant of mosquitoes for a long time. Lactic acid is predominantly produced by eccrine-sweat glands, creating

7676-434: The modern environmental movement, it became evident that the transformation of the swamp into agricultural land involved significant trade-offs and had effects on the ecosystem that had not been perceived in the first half of the twentieth century, when the major concerns had been the reduction of malaria-bearing mosquitoes and improving economic productivity. In 1963, a small (3.50 km) area of recreated papyrus swampland in

7777-504: The modified haemoglobin S molecules are exposed to low amounts of oxygen, or crowd together due to dehydration, they can stick together forming strands that cause the cell to distort into a curved sickle shape. In these strands, the molecule is not as effective in taking or releasing oxygen, and the cell is not flexible enough to circulate freely. In the early stages of malaria, the parasite can cause infected red cells to sickle, and so they are removed from circulation sooner. This reduces

7878-570: The north of the valley. More than 1,500 millimeters of precipitation falls on the Anti-Lebanon mountains only a few kilometers north of the valley, mostly in the form of snow, feeding underground springs and the sources of the Jordan River including the Hasbani River , Banias River , Dan River and the el-Malaha Brook, all eventually flowing through the valley, and which, before its drainage, could not easily be distinguished because of

7979-403: The north of the valley. The drying out caused the extinction of the unique endemic fauna of the lake, including the cyprinid fish Mirogrex hulensis or Hula bream, Oxynoemacheilus galilaeus or Galilean Stone Loach, and the cichlid fish Tristramella intermedia or Hulan shortjaw tristramella. Though perceived at the time as a great national achievement for Israel, with the advent of

8080-641: The noxious fever. The draining operations, carried out by the Jewish National Fund (JNF), began in 1951 and were completed by 1958. In 1955 the Israeli government invited John Zuckerman to visit Israel as advisor on a project. It was achieved by two main engineering operations: the deepening and widening of the Jordan River downstream; and two newly-dug peripheral canals diverting the Jordan at

8181-637: The parasite eventually disappears from that area, as happened in North America, Europe, and parts of the Middle East. However, unless the parasite is eliminated from the whole world, it could re-establish if conditions revert to a combination that favors the parasite's reproduction. Furthermore, the cost per person of eliminating anopheles mosquitoes rises with decreasing population density, making it economically unfeasible in some areas. Prevention of malaria may be more cost-effective than treatment of

8282-456: The prevention of bites. As of 2023, there are two malaria vaccines , approved for use in children by the WHO: RTS,S and R21 . The presence of malaria in an area requires a combination of high human population density, high Anopheles mosquito population density and high rates of transmission from humans to mosquitoes and from mosquitoes to humans. If any of these is lowered sufficiently,

8383-423: The quality of the land with respect to malaria and marshes that agriculture could be introduced safely. One of the new methods he initiated was the introduction of Gambusia fish to water sources in the country in 1923. The use of larvivorous fish to diminish mosquito populations was already well known at that time, e.g., the importance lies in the protocols used to define which of the known species of Gambusia

8484-411: The richest (71%) and the poorest (53%) households. Malaria is usually confirmed by the microscopic examination of blood films or by antigen -based rapid diagnostic tests (RDT). Microscopy—i.e. examining Giemsa -stained blood with a light microscope —is the gold standard for malaria diagnosis. Microscopists typically examine both a "thick film" of blood, allowing them to scan many blood cells in

8585-437: The screening and monitoring of infection to officially eradicate malaria. Research findings have predominantly relied on chemical explanations to explain the differences in attractiveness among humans based on distinct odor profiles. The existence of volatile compounds, like fatty acids, and lactic acid is an essential reason on why some individuals are more appealing to mosquitos than others. Volatile compounds Kanika Khanna,

8686-534: The southwest of the valley was set aside as the country's first nature reserve . Concern over the draining of the Hula was the impetus for the creation of the Society for the Protection of Nature in Israel . Draining the Hula turned out to be a mixed blessing. Water polluted with chemical fertilizers began flowing into the Sea of Galilee , lowering the quality of its water. The soil, stripped of natural foliage,

8787-563: The spleen. The blockage of the microvasculature causes symptoms such as those in placental malaria. Sequestered red blood cells can breach the blood–brain barrier and cause cerebral malaria. Due to the high levels of mortality and morbidity caused by malaria—especially the P. falciparum species—it has placed the greatest selective pressure on the human genome in recent history. Several genetic factors provide some resistance to it including sickle cell trait , thalassaemia traits, glucose-6-phosphate dehydrogenase deficiency , and

8888-612: The trait's survival, the trait is preserved in malaria-prone regions because of the benefits provided by the heterozygous form. Liver dysfunction as a result of malaria is uncommon and usually only occurs in those with another liver condition such as viral hepatitis or chronic liver disease . The syndrome is sometimes called malarial hepatitis . While it has been considered a rare occurrence, malarial hepatopathy has seen an increase, particularly in Southeast Asia and India. Liver compromise in people with malaria correlates with

8989-415: The urine with kidney failure may occur. Complications may include spontaneous bleeding, coagulopathy , and shock . Malaria during pregnancy can cause stillbirths , infant mortality , miscarriage , and low birth weight , particularly in P. falciparum infection, but also with P. vivax . Malaria is caused by infection with parasites in the genus Plasmodium . In humans, malaria

9090-424: The urine , retinal damage , and convulsions . The classic symptom of malaria is paroxysm —a cyclical occurrence of sudden coldness followed by shivering and then fever and sweating, occurring every two days ( tertian fever ) in P. vivax and P. ovale infections, and every three days ( quartan fever ) for P. malariae . P. falciparum infection can cause recurrent fever every 36–48 hours, or

9191-401: The vast majority of malaria deaths), P. vivax , and P. knowlesi (a simian malaria that spills over into thousands of people a year). P. ovale and P. malariae generally cause a milder form of malaria. Malaria is typically diagnosed by the microscopic examination of blood using blood films , or with antigen-based rapid diagnostic tests . Methods that use

9292-480: The workers in 1919." Kligler showed the ineffectiveness of previous methods used for the control of malaria in the country, namely, planting of Eucalyptus trees to dry the marshes, and the provision of Quinine prophylaxis for preventing infection. Kligler focused his studies on the larval stage of the mosquito life-cycle. He studied the prevalence of various Anopheles species, their biology and nesting grounds, tested different methods of eradication and selected

9393-427: The world where malaria is common were protected by an ITN. That number increased to 20.3 million (18.5%) African children using ITNs in 2007, leaving 89.6 million children unprotected and to 68% African children using mosquito nets in 2015. The percentage of children sleeping under ITNs in sub-Saharan Africa increased from less than 40% in 2011 to over 50% in 2021. Most nets are impregnated with pyrethroids ,

9494-590: Was a major issue in Mandatory Palestine , having been attested as endemic to the region since the biblical period . In the early 20th century, multiple malaria epidemics resulted in widespread deaths. The disease severely affected large areas of Palestine, including much of the land that was purchased by the Jewish settlement . Swampy and low-lying areas, in particular, allowed mosquitoes to thrive and made sustained human habitation impossible. However,

9595-543: Was best suited to the local conditions. The fish effectively reduced the number of mosquito larva surviving into adulthood. The result, combined with drainage techniques, was the almost total eradication of malaria in the upper Jordan Valley , i.e. the Huleh area, north of the Sea of Galilee. (Figure 3) In 1925, Kligler stated in a preliminary report that between 1922 and 1925, new malaria incidences had declined tenfold. In reality,

9696-477: Was blown away by strong winds in the valley, and the peat of the drained swamp ignited spontaneously, causing underground fires that were difficult to extinguish. Eventually part of the valley was transformed back into a wetland habitat. The work of a number of scientists and nature lovers made it possible for at least a small part of Hula's wetlands to be preserved. In 1964 the Hula Nature Reserve

9797-638: Was common throughout Mandatory Palestine, but by 1926, it had been nearly eliminated from the Upper Galilee and the Jezreel Valley . The anti-malaria campaign helped to increase the Jewish and Arab populations of the region. As large areas had been malaria-infested and uninhabitable for centuries, the efforts of Zionist settlers to clear malaria made it possible for them to expand and thrive. By draining swamps and implementing public health measures, they transformed previously unusable land into viable areas for agriculture and settlement, allowing for

9898-483: Was decided to develop the surrounding area and leave the flooded area intact. The new site has become the second home for thousands of migrating birds in the autumn and spring. The lake covers an area of one square kilometer, interspersed with islands that serve as protected bird nesting sites. It has become a major stopover for migrating birds flying from Europe to Africa and back, and also a major birdwatching site. In 2011, Israeli ornithologists confirmed that Lake Hula

9999-668: Was established in 1883 during the First Aliyah . In 1948 there were 35 villages in the Hula Valley—12 Jewish and 23 Arab. The Hula Valley lies within the northern part of the Syrian-African Rift Valley at an elevation of about 70 meters above sea level, and covers an area of 177 square kilometers (25 km by 6–8 km). On both sides of the valley are steep slopes: the Golan Heights to

10100-425: Was fed by several perennial springs. The lake attracted human settlement from early prehistoric times. Paleolithic archaeological remains were found near the " Daughters of Jacob Bridge " at the southern end of the valley. The first permanent settlement, Enan ( Mallaha ), dates from 9,000–10,000 years ago and was discovered in the valley. The Hula Valley was a main junction on the important trade route connecting

10201-493: Was officially inaugurated. The Hula Nature Reserve is listed by the Ramsar Convention on Wetlands, as a Wetland of International Importance. Hula Lake Park ( אגמון החולה ) is located in the southern part of the Hula Valley, north of the nature reserve and distinct from it. It was established as part of a JNF rehabilitation project. In the early 1990s part of the valley was flooded again in the wake of heavy rains. It

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