Malaria

What is Malaria?

Malaria kills almost 2,000 people every day. It is the most common and life threating parasitic infection of the human being. Malaria infects 210 million people and kills about 655.000 of them, 90% of death occurs in sub-Saharan Africa and South Asia and unfortunately, many of them are young children (younger than 5 years). Malaria is transmitted through 108 countries of 3 billion people. If you are living in a disease-free country, you can also be infected if you are travelling to areas where malaria is common. So, no one in the world is protected against this dangerous parasitic infection.

• Malaria is a life-threatening parasitic infection. The majority of cases occur in endemic areas
• Those travelling to countries with malaria can be infected easily
• Safe and effective antimalarial drugs are available for treatment and prevention of malaria

Prevention of Malaria

Although Malaria is a life-threatening disease, infection and death can be prevented. However, there is no malaria vaccine approved yet for human use. You can protect yourself against Malaria if you are living or travelling to a country where Malaria is common through covering your skin well, using insect repellant, and sleeping under a net. Also, it is indispensable to use antimalarial drugs for prevention.

What causes Malaria?

Malaria is a life threating disease caused by a parasite (Plasmodium protozoa). Infection occurs in tropical areas predominantly. The parasite is transmitted to humans through the bite of a female mosquito (Anopheles). There are five species of Plasmodium that can cause malaria in human.

5 types of Plasmodium parasite cause malaria in human:

• Plasmodium falciparum – Found in Africa, it's the most common type of malaria parasite and is responsible for the highest malaria deaths around the world 
• Plasmodium vivax – Found in South America and Asia, this parasite causes milder symptoms than, but can stay alive in the human liver for up to 3 years, which can cause cycles of Malaria.  
• Plasmodium Ovale – Not as common as the above 2,  and can be found in West Africa, this Plasmodium can remain in your liver for several years and not you may not show any signs.
• Plasmodium Malariae – Rare and mostly only found in Africa 
• Plasmodium knowlesi – Very rare and mostly found in some areas of southeast Asia

How is Malaria spread?

The female mosquito parasite spread the Plasmodium parasites. These mosquitoes are known to the locals as “night-biting” mosquitos, as they are known for biting humans between dusk and dawn, hence why you sleep with nets protecting the body in malaria danger zones.

Spread both ways 

If a human is already infected with malaria, and a mosquito bites the human, the mosquito can then become infected itself with the Plasmodium parasite and spread the parasite on to other humans.

After a bite

Once the mosquito bites a human, the parasite enters the bloodstream of the human and travels to the liver. Where the plasmodium multiplies and grows in number, before entering the bloodstream again and entering the red blood cells of the human. The parasites grow further in number and size when inside the red blood cells. The blood cells will burst due to the parasite infection and them back in the bloodstream.  This occurs every 2-3 days, and the human will feel fever symptoms such as chills and sweating.  

Other methods of transmission

A point to note is malaria can also spread through blood transfusions, and sharing of needles, but this rarely occurs.

Treatment

A simple medication against malaria can save you from the serious complications malaria infection can cause. There are many antimalarial drugs, which are effective in killing the parasite and preventing its infection.

Length of Treatment

The length of the course of treatment and the type of drug depended on:

• The species of Malaria infection
• Your age
• The symptoms severity
• If you are pregnant or not

For up to date Malaria advice for the region of the world you are travelling to, you can check Fit for Travel. or NICE

Common Anti-Malarial Medicines 

The most common antimalarial drugs include;

• Chloroquine (Avloclor)
• Combination of Atovaquone and Proguanil (Malarone)
• Doxycycline
• Quinine sulphate (Qualaquin) with doxycycline (Vibramycin, Monodox, others)
• Mefloquine (Lariam)

Avloclor (Chloroquine)

Chloroquine is widely used and preferred an antimalarial drug that can prevent and treat all species of Malaria. But, it is not used to treat or to prevent Malaria in areas where chloroquine is known not to work (resistance) and it is not used for the severe complicated form. It is available in tablet form. Chloroquine is the drug of choice for the prophylaxis and treatment of sensitive malaria species during pregnancy. 

Malarone (Atovaquone/Proguanil)

Malarone (Atovaquone/Proguanil) is a combination of two functioning antimalarial agents in one tablet. It is sold under the brand name of Malarone or in generic forms. Malarone (Atovaquone/Proguanil) can be used for both treatment and prevention of malaria. Malarone (Atovaquone/Proguanil) medications are used to kill the malaria parasites living inside red blood cells and other tissues. It is a short course effective treatment and prevention to save your life against Malaria

Doxycycline

Doxycycline is a broad-spectrum antibiotic It is effective against many bacteria species, used in the treatment of many infections, and in this case,  it is also used for malaria prophylaxis.

Symptom of Malaria

Symptoms and signs of Malaria begin within a few weeks after infection. However, some Malaria types can stay dormant in your body up to one year. People who get infected with malaria become very sick and present with;

• High fevers
• Shaking chills
• Flu-like illness
• Nausea and vomiting
• Sweating
• Muscle pain and fatigue
• Chest or abdominal pain
• Cough

Fever - stages of Attack 

The fever of malaria occurs in attacks (paroxysm). Each attack consists of different stages;

• The cold stage which is characterized by a feeling of cold and shivering for 1-2 hours
• Followed by a hot stage of high fever for 2-6 hours.
• At the end of it, the fever drops rapidly and the patient experiences excessive sweating (sweating stage). The attacks of Malarial can occur intermittently, or every day in some cases.

Serious Complications of Malaria

Most cases of Malaria deaths are related to serious complications. Therefore, early detection and treatment is very important.

• Cerebral malaria: Red blood cells which contain the parasites block the brain blood vessels and brain damage occurs
• Breathing problems
• Anaemia: Malaria damages your red blood cells causing anaemia
• Organ failure: Malaria can cause liver or kidney failure
• Low blood sugar: can cause coma and death

When to Consult a Doctor

You have to consult a doctor if you have attacks of fever and have recently travelled to an endemic area. If your symptoms are severe symptoms, ask for urgent medical care. Fortunately, the disease can be controlled and treated by many effective drugs.