Malaria - Causes, Symptoms, Diagnosis, Prevention & Treatment
Health Education

Malaria

Authored by DesiMD Doctor on 20 Mar 2013 - 13:15.

Malaria is an infection caused by a parasite called Plasmodium. It is an overwhelming problem in countries all over the world with warm and humid climates.
Plasmodium is transmitted by a bite from the Anopheles mosquito. They first travel to the liver where they mature, then attack and destroy human red blood cells. As a result, the infected person develops anemia (lack of red blood cells in the blood which limits oxygen delivery to the body). The severe form can also lead to organ injury by accumulating within and clogging small blood vessels.

There are several species of Plasmodium that infect humans and vary in the way they behave when they attack the human body.
•  Plasmodium falciparum malaria can be much more acute and severe than malaria from other Plasmodium species. It tends to be associated with more severe infections such as cerebral malaria and severe anemia, organ injury, and higher death rate. Plasmodium falciparum tends to make the infected red blood cell very sticky, causing them to accumulate and block blood vessels within different organs of the body such as the heart, lung, brain, liver and kidneys
•   The other types of malaria include Plasmodium vivax, P. ovale, P. malariae, and P knowlesi. Compared with P. falciparum, these species have lower levels of parasite load, are less often associated with severe inflammation and obstruction of blood vessels, and have a much lower death rate. However, they can still lead to injury, especially of lung and spleen, in severe cases

Symptoms of malaria do not develop immediately after the parasite enters the body from an infected mosquito bite. Rather, it takes around1-4 weeks for malaria parasites to start reproducing in the bloodstream to a point where symptoms occur.
Malaria can present very suddenly or the symptoms can develop very subtly and slowly.
Uncomplicated malaria presents with a general febrile illness and do not localize to a part of the body.
Symptoms include:
●    Fevers, which can be very high, and chills – fevers can be continuous or cyclical (every 2-3 days) depending on the species
●    Headaches
●    Weakness/fatigue
●    Night sweats
●  Less consistently, symptoms of uncomplicated malaria include muscle and joint aches, trouble sleeping, and diarrhea
As you may guess, the non-specific clinical presentation of uncomplicated malaria can overlap with many other types of infections and thus need laboratory testing.
Severe or complicated malaria means that there is associated organ injury. One example is cerebral malaria (malaria of the brain) often manifests with seizures or coma. Other severe complications include respiratory failure from fluid build-up in the lungs, rupture of the spleen, kidney injury, and uncontrolled and/or severe inflammatory response in the body. Sometimes blood transfusions are required for the degree of anemia from malaria. Persons who develop a febrile syndrome with trouble breathing or an altered mental state should seek immediate medical help, as complicated malaria is one of many severe infections that can present this way.

Malaria can be found with preparing a sample of blood on a slide and looking for the parasites under the microscope, called a thick and thin blood smear. The thick smear looks at concentrates of red cell layers and screen for presence of parasites while the thin smear is used to determine the Plasmodium species, which is important in determining the right treatment.
While blood smears remain the standard for diagnosis, recent rapid diagnostic tests have been developed which are becoming more frequently used, though these are limited to detecting falciparum species.

• Pregnant women and fetuses are more vulnerable to complications of malaria. Malaria can invade the placenta, which is dangerous to the mother and the baby. It can lead to growth retardation, premature delivery, low birth weight, and death of the newborn
•   Young children and elderly
•   People with deficiency in their immune systems (such as HIV)

There are now several anti-malarial agents used to cure malaria infection. Chloroquine is commonly used in areas of the world where there is no resistance, though there has been emergence of chloroquine resistance in parts of India. It is considered safe for use in pregnant women. Other agents include sulfaxoxine-pyrimethamine, malarone, doxycycline, mefloquine, quinidine, and quinine.
For uncomplicated malaria (no organ damage), the World Health Organization guidelines from 2010 recommend using a combination therapy with 2 or more antimalarial medicines, one of them being an artimesinin-based agent (such as artesunate, artemether, or dihyroartemisinin). The rationale is that these agents are thought to act faster to reduce the parasite load and there is less resistance compared with other anti-malarial drugs.
Uncomplicated malaria can usually be treated outside of the hospital. On the other hand, complicated or severe malaria is a medical emergency and usually requires close observation in the hospital. It is often treated with fast-acting medicines delivered through the veins, such as artesunate, artemether, or quinine followed by oral medicines. Additionally, supportive care and treatment of the underlying organ injury is often required.

 

Currently, there is no malaria vaccine though there have been some vaccine candidates still being studied.
•   Wearing insect repellant with DEET
•   Using mosquito coils
•   Wearing clothes and footwear that cover as much skin as possible
•   Using mosquito screens and mosquito nets
•   Avoid leaving still bodies of water with pots and pans. These attract mosquitoes

*Disclaimer This is not medical advice. The content is for educational purposes only. Please contact your doctor for any health care issues.