Malaria

Malaria is a very serious infection, common in tropical countries such as parts of Africa, Asia and South America, transmitted from a bite from an infected mosquito.. The most common symptom is fever and a flu-like illness. Malaria can occur even up to a year after travelling in an area in which there is malaria. Prompt treatment for malaria is essential, as without treatment malaria can be fatal.

It is caused by a parasite called plasmodium . The parasite is passed to humans from a mosquito bite.

There are four types of plasmodium that cause malaria. These are called Plasmodium falciparum, Plasmodium vivax, Plasmodium ovale and Plasmodium malariae. Plasmodium falciparum is usually the most serious of the four.

It is estimated that worldwide there are 300-500 million cases of clinical malaria each year and about 40% of the world’s population is at risk of acquiring malaria.

How is malaria transmitted?

The plasmodium parasite is usually transmitted by a particular species of mosquito, which is the anopheles mosquito. If a female anopheles mosquito bites a person who is infected with malaria, the mosquito can then carry the plasmodium parasite and spread it to others when it bites and feeds from other people’s blood.

When the plasmodium parasite enters the blood, it travels to the liver and then re-enters the bloodstream where it can invade the red blood cells. Eventually, these infected red blood cells burst which leads to them releasing even more of the tiny parasites into the blood. These infected red blood cells tend to burst every 48-72 hours. Each time they burst, an episode of chills, fever and sweating is experienced.

What are the symptoms of malaria?

There are two general types of malaria: benign and malignant. Benign malaria is milder and relatively easy to treat. Malignant malaria can be very severe and can sometimes be fatal.

Symptoms of malaria usually occur between one to four weeks after the initial mosquito bite. However, in some cases, depending on the type of infecting plasmodium, it can take up to a year before any symptoms start to show. Benign malaria

The most common symptom of benign malaria is a high fever. However, the absence of fever in an ill person does not exclude the diagnosis of malaria.

Other symptoms of benign malaria may include:

Headaches, muscle pains, abdominal pains, cough, feeling more tired than usual and feeling generally unwell.

Children are more tired and can have diarrhoea and/or vomiting.

The fever in most people has no specific pattern and may present 1-2 days after the symptoms start. If the malaria infection becomes established, then malarial symptoms can come in cycles, occurring every 2-3 days (see above).

Malignant malaria

Malignant malaria is caused by Plasmodium falciparum. Malignant malaria usually begins with similar symptoms to benign malaria, but will often lead to the development of complications, such as breathing problems, liver failure and shock. Malignant malaria can also affect the brain and central nervous system which can even lead to death.

How is malaria diagnosed?

If malaria is suspected then medical advice should be sought without delay. A blood sample taken and be examined for the presence of the malaria parasite. If the first blood test is negative but the doctor suspects you have malaria, then another blood test taken a couple of days later.

How is malaria treated?

If malaria is promptly diagnosed and treated, most people make a full recovery. Malaria is normally treated using anti-malarial medicines. Quinine, chloroquine and artesunate are some of the different types of medicines available.

The type of medicine prescribed and the duration of treatment can vary from person to person. It depends on various factors such as the type of malaria one has, if one has taken any anti-malarial medication, and the severity of symptoms. If the symptoms are mild then treatment can take place at home. However, infection with Plasmodium falciparum malaria may require treatment in hospital.

Some people are given more than one type of medication or an alternative medication if they develop side-effects to a medication. Resistance to anti-malarial medicines has spread rapidly over the past few decades, especially resistance to Plasmodium falciparum. If the first anti-malarial medicine that prescribed fails to improve symptoms, a variety of other medicines may be tried as part of treatment. The treatment for malaria leaves a patient feeling very weak and tired for several weeks afterwards.

How can malaria be prevented?

  • Awareness of risk of malaria.
  • Bite prevention.
  • Chemoprophylaxis (taking anti-malarial medication regularly and exactly as prescribed).
  • Prompt diagnosis and treatment.

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