HIV/AIDS and Malaria: A Deadly Combination
159th Independence Day Commentary
Syrulwa Somah, PhD
How HIV/AIDS destroys the body defense system
The human body, like a nation, has its military unit or radar system that attacks any invading force or forces that violate its territorial integrity. The military or radar system is commonly referred to as the immune system. The immune system is made up of expert cells in the bloodstream that are capable of combating invading germs and viruses to keep the body functioning healthy. Various names such as "T" cells or "T4," "helper-T," or "CD4" cells which are the central commend or brains of the operation, are used to described the military or radar units of the body that are on guard non-stop to track germs. As soon as a germ enters the body, these white blood cells identify the invaders and give command to the military unit-type cells, which then declare an all-out “civil war” on the various germs, bacteria, viruses, cancers, fungi, and parasites that can make a person sick.
Like all viruses, HIV has one objective in life, which is self-reproduction or self-preservation. In other words, as soon as the HIV/AIDS virus attacks and moves into a “T” cell, it not only changes that cell’s whole chemistry into a “virus factory”, but the “virus factory” also produces so many new viruses in the cell that the “T” cell cannot handle so it explodes, thereby scattering the HIV back into the bloodstream. It is like pumping air into a balloon that pops the air when it exceeds the capacity of the balloon. When that happens, the virus goes on to look for new “T” cells and starts the process all over again. As long as the HIV virus is in the person’s bloodstream, it can destroy virtually all of an infected person's “T” cells using the same tactics.
Symptoms that are associated mostly with the vector of AIDS include abscess, lack of energy, unexplained weight loss, frequent fevers and sweats, frequent yeast infections (oral or vaginal), continual skin rashes, flaky skin or pale skin, white patches or spots inside or around the mouth, pelvic inflammatory disease in women that does not respond to treatment, and short-term memory. HIV/AIDS also produces opportunistic infections symptoms such as shortness of breath, seizures, coughing, lack of coordination, difficult or painful swallowing, fever, vision loss, nausea, shingles, abdominal cramps, vomiting, severe and persistent diarrhea, weight loss and extreme fatigue, severe headaches, and coma.
Now, when the HIV conquers majority of the CD4 cells or inflict serious damage or infections, a person then has AIDS. When someone has AIDS, it means that he or she has less than 14 percent or 200 CD4 cells per cubic millimeter (a size of maggi cube that Liberians cook in their soup) of blood. An adult person who is healthy has CD4 and “T” cell counts of 1,000 plus.
How malaria destroys the body defense system
In the case of malaria parasite, when it enters the
body by a mosquito bite, the parasite recedes from circulating
blood within an hour and congregates in the liver. Several
days later, infected red blood cells (RBCs) with merozoites
emerge from the liver and the merozoites invade and
destroy other red blood cells in the human body. As
the destruction of red blood cells spills wastes, toxins,
and other debris into the blood, the human body responds
by producing fever, an immune response that speeds up
other immune defenses to fight the foreign invaders
in the blood. The fever usually occurs in intermittent
episodes, which begins with sudden headache, muscle
ache, malaise, nausea, vomiting, diarrhea, coughing,
violent chills (or what we called in Liberian the person
trembling), followed by an intense fever and then profuse
sweating. Upon initial infection with the malaria parasite,
the episodes of fever frequently last 12 hours and usually
leave an individual exhausted and bedridden. Repeated
infections with the malaria parasite can lead to severe
anemia, a decrease in the concentration of red blood
cells in the bloodstream because the malaria parasite
usually consumes or renders unusable the proteins and
other vital components of the infected person’s
red blood cells.
Untreated, the sporozoites divide repeatedly to form 30,000 to 40,000 merozoites in liver cells over the course of one to two weeks. The colony of merozoites departs the liver to enter the bloodstream, where they invade red blood cells. While in the blood cells, the merozoites multiply quickly thereby forcing the red cells to burst, while releasing into the bloodstream a new generation of merozoites that go on to infect other red blood cells until serious organ failures occurs from severe malaria. Some of the severe malaria include cerebral malaria, meaning an abnormal behavior that causes impairment of consciousness, seizures, coma, or other neurologic abnormalities; hemoglobinuria or urinating with blood due to hemolysis; cardiovascular collapse and shock, acute kidney failure; excessive acidity in the blood and tissue fluids, and decrease in blood platelets), are just few examples of how malaria can further weaken the immune system of someone who is HIV/AIDS positive.
Considering HIV/AIDS and malaria synergistic behavior of the body defense system and symptoms, imagine a Liberian, your brother, sister, mother, father, husband, son, or daughter has HIV/AIDS or he or she already has a weakened system or 14 percent CD4 cells and is stricken with the deadly malaria. At this point his or her immune system will no longer recognize and fight off common organisms. Besides malaria and HIV/AIDS working on the body, there are other organisms that may be lying dormant or inactive in the body already, or may invade from the integumentary system or environment. In other words, weakened immune system can cause an opportunity for an opportunistic infection (a dormant parasite) to wake up, multiply, and cause illness.
The phrase "opportunistic infections" is used to describe illness that are in the body which could cause any harm when the “T” cells are very strong and healthy to the point that those with fully functioning immune systems are almost never troubled by these "opportunistic infections.” In terms of "opportunistic infections” our nation has a ton of them. HIV/AIDS have found a treasure trove of opportunities to thrive among our tragic conditions egged on or fueled by civil war, poverty, abuse, violence, prejudice and ignorance. For example, it was reported that after screening ex-combatants during the de-mobilization process, sexually transmitted infections (STIs) prevalence rate stood at 93 percent for male, while female prevalence rate stood at 83 percent. And the general population STIs prevalence rate is around 75-80 percent. In other words, the STIs go far beyond former combatants and touch the general population. Among the different 35-50 known STIs, herpes, gonorrhea, syphilis, Chlamydia, and trichomoniasis were diagnosed with the general population who were screened.
In deed, Liberia has serious health problems that challenge all of us to provide the blueprint for elimination of the HIV/AIDS and malaria diseases so that we can concentrate on the bigger challenges. Malaria, together with HIV/AIDS, STIs and TB, will not only increase the death rate in our nation but also pose major public health challenges, thereby undermining the development of our nation, and fostering population extinction, so we need to take concrete action to reverse this trend. Our future generation and their generation are threatened because many children with HIV infection do not only gain weight or grow normally, but also HIV-infected children frequently are slow to reach important mental development and milestones in cognitive skills such as physical growth, crawling, and walking and speaking, which are key factors that define our social, spiritual, intellectual, environmental, and emotional characteristics. Therefore, we must guard our children against HIV/AIDS and malaria because as these diseases progress in our children, the children are likely to develop neurological problems such as difficulty walking, dull performance in school, seizures, and other symptoms of neurological dysfunction and disease.
We can have all the independence celebrations and elections we want and spend 200 million dollars on the military, but without the creative talents of all the sons and daughters of our nation to defeat these diseases, our military personnel won’t be strong enough to protect our boarders, our farmers would be too weak to feed our nation, our future generation would be too sick to learn, our teachers too weak to teach, our employees too weak to work, and our women too sick to bear children. The end result would be the loss of autonomy and dependency on other people to feed us. And if we cannot protect our boarders, feed ourselves, and govern our nation, we would only exist in name.
I believe, my Liberian compatriots, while we still have eyes to see for our nation, while we still have legs to walk for our nation, while we still have ears to listen for our nation, while we still have minds to think our own thoughts for our nation, and while we still have mouths to speak power to true for our nation, let us begin combating malaria with these divine gifts of God and defeat it as soon as possible before it gets out of hand. And while we still have time, let us use these divine gifts of God to not only guarantee independence for the next generation who are coming after us, but to also give them the gift of life. I think anyone who believes in the independence of Liberia and loves the next generation of Liberians ought to join in the fight against HIV/AIDS and malaria regardless of personal or organizational differences. Malaria eradication in Liberia should be the pre-requisite to channeling all our energies in the combat of HIV/AIDS and sustaining our nationhood and longevity. Therefore, to effectively and efficiently combat the HIV/AIDS epidemic, malaria, which unlike HIV/AIDS is curable, must be eradicated so that it doesn’t continue to bring additional pressure to bear on the healthcare sector of our country and take money away for treating HIV/AIDS, which is not curable at this time. Our collective and individual action on malaria eradication is a moral imperative and must demand resolve from us all to actively strive for malaria free Liberia so that the God of our parentage can reward us for our courage to reprieve ourselves from the violence of these fragile flies that keep us underdeveloped.
Happy Independence Day! Long live Liberia!
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