What is Malaria?
Malaria is a mosquito-borne infectious disease affecting humans and other animals.
This disease sometimes becomes life-threatening and is caused by single-celled microorganisms known as plasmodium that are transmitted to people through the bites of infected female Anopheles mosquitoes. It is a severe relapsing infection in humans. But the point for relaxation is that this disease is preventable and curable.
Fever, vomiting, tiredness, and headache are the main symptoms of malaria.
According to WHO in 2022, malaria infected around 249 million people worldwide. Also, around 608,000 people died in 85 countries in 2022 (1).
This disease is commonly associated with poverty and has a noteworthy negative effect on economic development. About 94% of the malarial cases (233 million) and 95% of deaths related to it (580,000) occurred in The WHO African Region (1).
Moreover, the disease is common in tropical or subtropical countries and not so common in countries with temperate climates.
This article is all about giving you complete information about malaria, i.e. causes, types, symptoms, diagnosis, tests, vaccination, transmission, prevention, treatment, and side effects of malaria.
What are the Causes of Malaria?
Single-celled protozoan parasites called Plasmodium are responsible for causing Malaria. The parasites get transmitted to the human body, with the help of an infected female Anopheles mosquitoes bites. As the mosquito bites, the parasite gets released into the human bloodstream. After the parasite enters the body, it transmits to the liver, matures there, and begins to infect the RBCs. These parasites take almost 48 to 72 hours to multiply themselves in the RBCs and to burst the infected blood cell. If the process of parasites infecting the RBCs continues like this, it results in the occurrence of malaria symptoms which occur in cycles that last for two to three days at a time.
What are the Types of Malaria?
The parasite responsible for causing Malaria in humans is known as Plasmodium. It is a single-celled parasite. There are 5 main species of Plasmodium parasite that infect humans and cause malarial illness and that are:
1) Plasmodium knowlesi (P. knowlesi or P.k.)
Knowlesi malarial parasite is mostly found in Southeast Asia, mainly in Malaysia. People affected by malaria due to this parasite can be either severe or uncomplicated, based on various factors.
2) Plasmodium ovale (P. ovale or P.o.)
P. ovale is the rarely found Malarial parasite and might also be a less severe illness. This parasite has become the reason for malaria for people in tropical regions of Western Africa such as Nigeria, Ghana, etc.
3) Plasmodium vivax (P. vivax or P.v.)
P. vivax malaria is predominant in Latin America, Asia, and a few regions in Africa. Almost 60% of malaria cases in people are because of this parasite. The symptoms for this parasite is similar to that of the flu.
4) Plasmodium malariae (P. malariae or P.m.)
P. malariae species is found worldwide and has a quartan cycle (three-day cycle). If untreated, it can cause a long-lasting and chronic infection that in some cases can last for a lifetime. In some chronic cases, this species can cause serious complications such as nephrotic syndrome.
5) Plasmodium falciparum (P. falciparum or P.f.)
Falciparum is the most dangerous and deadliest malarial parasite. This parasite is responsible for causing the highest number of malaria-related deaths. It is majorly found in Africa, South America, and Southeast Asia. This life-threatening malarial parasite may also result in some other severe issues.
What are the Symptoms of Malaria?
Typically, the human body infected by any of the malarial parasites starts to show symptoms or signs within the first few weeks of the mosquito bite. Moreover, some parasites of malaria may live in the human body for years.
The common symptoms of malaria may include:
- Chills that can range from moderate to severe
- High-grade fever
- Profuse sweating
- Cough
- Rapid heart rate
- Rapid breathing
- Fatigue
- Muscle or joint pain
- Abdominal pain
- Diarrhea
- Nausea and vomiting
- Headache
- A general feeling of discomfort
- Anemia
- Bloody stools
- Convulsions
- Coma
Some people affected by malaria may experience cycles of malarial attacks. Typically, these attacks begin with chills and shivering, then high fever, sweating, and then the body returns to the normal temperature.
How is Malaria Diagnosed?
Malaria should be diagnosed promptly in order to treat the patient in time. This also helps to prevent the further spread of infection in the community through local mosquitoes.
This disease must be considered a possible medical emergency and should be treated accordingly. Delayed diagnosis and treatment are important causes of death in patients suffering from malaria.
For the diagnosis of malaria, your doctor will review your health history, including any recent travel to tropical regions, and conduct a physical exam.
Your doctor will be able to decide if you have an enlarged liver or spleen. If you have symptoms of malaria, then to confirm the diagnosis, your doctor may order additional blood tests. These blood tests will show:
- Whether you have malaria by showing the presence of the parasite in the blood
- Which type of malaria parasite is causative of your symptoms
- Whether your infection is caused by a parasite that is resistant to certain drugs
- If the disease is causing any serious complications
Some blood tests can produce results in less than 15 minutes while others can take several days to complete. Depending on your symptoms and to evaluate possible complications, your doctor may order additional diagnostic tests.
Test for Malaria
If you find yourself symptomatic for malaria, it is the time when you should opt for a test for confirmation.
There are two varieties of recommended tests to diagnose malarial parasites and these are:
- Blood smear test and
- Rapid diagnostic test.
Blood smear test
The blood smear test is done by putting a blood drop on a special slide. The slide is then examined by the laboratory professional. The examination takes place by putting the slide under a microscope and looking for malarial parasites.
Rapid diagnostic test
For the rapid diagnostic test, the laboratory professional looks for the proteins that parasites release in the human body. This protein is known as antigens. The rapid diagnostic test may give a rapid result when compared to the blood smear test. But a blood smear test is recommended due to its more accuracy.
Malaria Vaccine
A vaccine is a drug or any other related biological preparation that provides active acquired immunity to a specific infectious disease.
Thus, a malaria vaccine is used to prevent malaria.
The development trial of malaria vaccinations started in 1960. But there were many hurdles that resulted in development failure many times. The early obstacles were:
- The technical difficulties of developing any vaccine to fight a parasite.
- Lack of developers
- Lack of traditional market
But 6th October 2021 proved to be the historic day in this development process. WHO (World Health Organization) showed the green flag for the widespread use of RTS,S/AS01 (RTS,S) vaccine for the prevention of malaria. It was the only approved vaccine till 2021, for preventing malaria. This vaccine is typically called by the brand name Mosquirix. The RTS,S/AS01 (RTS,S) vaccine becomes effective after successfully taking 4 doses of it.
Researchers are also actively doing more research to bring a more effective malaria vaccine. R21/Matrix-M is also a vaccination for malaria which is under development. The initial trials prove it the most effective vaccine which has an efficacy rate of 77%. Its antibody levels are also higher than RTS,S/AS01 (RTS,S). This is the first vaccine that meets WHO guidelines stating that the malaria vaccine should have at least a 75% efficacy rate.
Transmission of Malaria
As we already discussed, malaria is caused when a mosquito infected with malaria parasites bites a person. Furthermore, if an uninfected mosquito bites the person with malaria symptoms, the mosquito may get infected and transmit the parasite to other humans too. In this way, the humans and mosquitoes that get exposed to the parasite of malaria become the reason for the transmission of malaria. The rate of transmission of malaria in any particular area depends on the number of people inoculated with parasites of malaria by infected mosquitoes.
Moreover, malaria is not a contagious disease. That means it does not spread with physical contact with the person who is suffering from this illness. But, there are some other modes with which Malaria parasites may transmit from one person to another, and these are:
- Sharing of needles used for injecting drugs.
- Through blood transfusions.
- From a woman who is pregnant to her child in the womb.
A person can get this parasite and suffer from malarial infection more than once.
Prevention of Malaria
Malaria is a preventable disease. One can adopt certain precautions in advance to protect themselves from getting infected with this illness. For this, you can consult and take guidance from your healthcare provider. Moreover, if you live or travel to any place where the spread of malaria is common, you can ask your healthcare consultant to provide medications for prevention. The usual doses of malaria preventive drugs are before, during, and after the journey.
One should also adopt certain precautions to prevent the body from bites by the mosquito.
This can be achieved with:
- Vaccinating children who live in places where malaria is endemic
- Do not allow water to stagnate because this can serve as the breeding place for Anopheles mosquitoes, and cause an increase in the spread of the malaria fever wherever they go.
- Mosquito repellent or other effective chemicals should be sprayed on water bodies to keep the mosquito population under control.
- Use clothes having long sleeves and pants to wear whenever going outside.
- Make use of mosquito netting to drape over the bed when there is a lack of screen or air conditioner in the bedroom.
- Use insect repellent namely permethrin for treating sleeping bags, tents, mosquito nets, clothes, and other fabrics.
- Keep your windows and doors closed. You can use a screen for this.
- To protect the exposed skin, use the mosquito repellent with DEET (diethyltoluamide) to prevent mosquito bites. The repellent should have at least 20 to 35% N, N-Diethyl-meta-toluamide (DEET).
- If you need or want to wear thin clothes, spray a repellent or insecticide over clothing, as mosquitoes may be able to bite over thin clothes.
What is the Treatment of Malaria?
The treatment for malaria is more effective and the patient makes full recovery with early diagnosis and treatment.
Treatment for individuals suffering from malaria includes (2):
- medication to eliminate the parasite from the bloodstream
- supportive care
- hospitalization for those having severe symptoms
- intensive care, in few cases
Your doctor will prescribe some drugs to kill malarial parasites. These drugs are also known as antimalarial drugs.
The commonly used antimalarial drugs to treat malaria are:
- Chloroquine phosphate
- Artemisinin-based combination therapies (ACTs)
- Primaquine phosphate
- Quinine sulfate with doxycycline
- Atovaquone-proguanil
The type of drugs and duration of treatment that will be effective depends on certain factors. These factors include:
- Type of malaria parasite
- Severity of symptoms
- Age
- Travelling history
- Family history
- Medical history
- Pregnancy
- Whether the patient took antimalarial drugs before
Moreover, if the patient develops complications he/she may need a combination of medications.
The majorly recommended and prescribed antimalarial drugs should contain chloroquine, doxycycline, and a mixture of proguanil and atovaquone.
Side Effects of Taking Medications of Malaria
As we have already discussed, antimalarial drugs are used for the prevention as well as treatment of malaria. These medications or drugs may have certain side effects on the human body depending on its nature. Some of the side effects of using antimalarial drugs on humans may consist of:
- Ringing in the ears (tinnitus)
- Vision problems
- Psychological disorders
- Insomnia
- Vivid dreams
- The body becomes more sensitive to sunlight
- Convulsions
- Headaches
- Gastrointestinal (GI) issues such as nausea and diarrhea
If you are taking any other medications or have any other health issues, it is recommended that you consult the doctor before using any drug. The health care professional will be better able to suggest the use and doses of antimalarial medicines.
This is all about the disease malaria and other related facts. Hope this information has helped you. The disease is easily preventable and treatable if treated correctly and at the correct time.
What are the Complications of Malaria?
Some individuals are more likely to suffer from serious health problems or complications if they get malaria, like:
- Older people
- Children and infants
- Pregnant women and their unborn children
- People who travel from places that don’t have the vaccine
Malaria has various serious complications. These serious health problems or complications can include:
- Cerebral malaria (a form of severe malaria that involves encephalopathy)
- Coma
- Pulmonary edema
- Liver, kidney, and spleen failure
- Very low blood sugar
- Anemia
Malaria in pregnant women is an important cause of stillbirths, infant mortality, low birth weight, and miscarriage mainly in P. falciparum infection, and sometimes with P. vivax infection.
The Long-Term Outlook for People with Malaria
People with malaria when properly treated usually recover completely. But, severe malaria can progress very rapidly and can cause death within hours or days.
In most severe cases of malaria, fatality rates can reach up to 20% even with intensive care and treatment.
Without treatment, depending on the type of malaria parasite, symptoms may last from 2 to 24 weeks (2). After they disappear, depending on the type of infection, a relapse may occur from months up to 20 years later.
If a person with malaria develops complications, then the outlook may not be good.
The long-term outlook may also be poor for patients with drug-resistant parasites. Malaria may recur in these patients and cause other complications.
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References:
1) Malaria
https://www.who.int/news-room/fact-sheets/detail/malaria
2) Malaria
https://www.ncbi.nlm.nih.gov/books/NBK551711/
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Disclaimer: This article is intended for informational purposes only. Any information associated with this article should not be considered as a substitute for prescriptions suggested by local healthcare professionals.
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