Malaria: Epidemiologic Triangle & Prevention Levels

The Epidemiologic Triangle of Malaria

The epidemiologic triangle is a model that is used by health professionals to study and understand underlying health challenges using three vertices, namely agent, host, and environment. The agent represents the microbe that triggers the infection, while the host denotes the organism harboring the infection. The environment consists of all external factors that come into play to cause or allow the transmission of the infection (Baird, Bangs, Maguire, & Barcus, 2002).

Malaria is an infectious disease not only because it is caused by microbial agents, but also because it is passed from person to person. Available scholarship demonstrates that an epidemiologic triangle is an effective tool in assisting health professionals to understand the transmission of malaria (Snow, 2015). Indeed, it is documented that “the risk of malaria is highly dependent on interactions between the host, parasite, mosquito vector, and environment, a relationship known as the epidemiological triad of disease” (Baird et al., 2002, p. 13). The host in the epidemiological triangle of malaria is the human being who provides the vector with a means of survival through the blood meal.

Moving on, the agent represents the microbes that cause malaria, namely “Plasmodium falciparum, P. vivax, P. malariae, related sibling species of P. ovale, and P. knowlesi” (Snow, 2015, p. 1). Environmental factors which trigger malaria outbreaks in most regions include rainfall, attitude, and temperature; however, the actual transmission of malaria requires mosquito vectors in the genus Anopheles (Baird et al., 2002). In environmental factors, it should be noted that high relative humidity enhances mosquito life-span (Snow, 2015) and that vectors survive and are capable of transmitting the disease within the temperature range of 20-30°C and humidity level of less than 60% (Baird et al., 2002).

Levels of Prevention

Infectious diseases such as malaria can be prevented and managed using primary, secondary, and tertiary levels of prevention. In epidemiological contexts, primary prevention entails reducing malaria transmission by decreasing the human and relevant vectors, minimizing the vector population density in critical areas, as well as changing vector longevity with the view to reducing the incidence of disease (A Guide to Malaria, 2006). Primary prevention can therefore be achieved by using skin repellants, spraying houses with insecticides, draining stagnant water, and clearing bushes, among others.

Secondary prevention entails “controlling and reducing individual risks by using the full range of personal protection and behavior modification measures” (A Guide to Malaria, 2006, p. 8). Some examples of secondary prevention strategies for nurses include facilitating awareness and education of the risk of malaria, encouraging the use of personal protection measures such as proper clothing, ensuring that patients comply with chemoprophylaxis, as well as assisting in the prompt diagnosis and early treatment of malaria. Tertiary prevention entails implementing strategies that aim to minimize the number and/or impact of complications arising from the disease. Here, a good strategy would be to undertake long-term management of individuals presenting with repeat malaria complications (Rudman, 2004).

Lastly, nursing professionals have significant roles to play in the prevention and management of malaria. Broadly, these roles include (1) advancing educational and awareness campaigns on the existing malaria prevention strategies and approaches, (2) ensuring that sick patients are diagnosed properly and managed quickly using the right chemoprophylaxis, and (3) taking part in malaria surveillance and distribution of insecticide-treated nets (ITNs) to encourage proactive prevention as opposed to reactive treatment and management of the disease.


A guide to malaria management programs in the oil and gas industry. (2006). Web.

Baird, J.K., Bangs, M.J., Maguire, J.D., & Barcus, M.J. (2002). Epidemiologic measures of risk of malaria. In D.L. Doolan (Ed.), Methods in molecular medicine, vol. 72: Malaria methods and protocols (pp. 13-22). Totowa, NJ: Humana Press, Inc.

Rudman, M.S. (2007). Diagnosis dilemma: Is it severe malaria? Medical Journal of Therapeutics Africa, 1(1), 41-44.

Snow, R.W. (2015). Global malaria eradication and the importance of plasmodium falciparum epidemiology in Africa. BMC Medicine, 13(1), 1-3.

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