Malaria - Health Center
By Refadoc, Posted on : Tuesday, 15 September 2015 - 10:46 am IST
Malaria – A Basic Overview
Malaria is a mosquito borne infection which occurs in humans and other primate animals due to the parasites carried by the mosquitoes. One of the major symptom of this disease is high chills and fever. Areas such as Africa, South Asia, Central America and South America are prone to malarial infections.
Malaria spreads due to a bite from the female anopheles mosquito which carries the parasite of the disease. However, in some of the rarer cases, the disease can spread when a person comes in direct contact with the blood of the infected person. Also, a developing foetus too is at risk of contracting the disease from its mother. However, being in the vicinity of an infected person does not get you contracted with the disease.
Some of the major symptoms of the disease are flu, high fever, chills as well as muscular pains. The symptoms of the disease tend to come and go in different cycles. If left untreated, it can cause severe damage to the vital organs such as brain, kidneys, heart or lungs. A blood test is usually conducted in order to determine if a person is suffering from malaria.
Medications are available in the market for the treatment of the disease easily. However, in some of the rarer cases, the malarial parasites can survive despite the medication if they are present in the liver and tend to become resistant to the medicine.
Causes of Malaria
A bite from the mosquito which has been infected with the parasite is one of the major causes for the spread of Malaria. There are five known species of Plasmodium which are known to infect people and cause the disease.
ü P. Falciparum: This parasite is found basically in the tropics and the subtropics (the equatorial zones). Infection caused by P. Falciparum can lead to serious complications after the first few days of the infection. This parasite is known to be very resistant to the anti-malarial medication and needs to be treated with other medications.
ü P.Vivax, P.Malariae, P.Ovale and P. Knowlesi are other leading parasites which can cause malaria. Though their infections are not life threatening, the person may take a month’s time to recover from the disease. Infection from P. Knowlesi can prove to be fatal.
How does Malaria Spread?
Malaria can spread when the female Anopheles Mosquito which has been infected with the parasites bites a healthy person. This is the only known species of mosquito which carries the parasite within its body. This mosquito, upon biting an infected person, draws out the blood which contains the strains of the parasite. Later, when this mosquito bites a healthy person, it can transfer the same parasites to the infected person leading to the infection.
The Female Anopheles mosquito is known to bite primarily between the time periods of 9 pm to 5 am. Once the parasite has entered the human body, it gets itself lodged in the liver, where they effectively multiply to about 10,000 times. The incubation period of the parasite is two weeks after which the parasite bursts itself onto the bloodstream leading to infecting the red blood cells in the body.
Signs and Symptoms of Malaria:
Malaria tends to begin with the flu like symptoms. In the initial stages, the infections are of a similar nature amongst the different strains of the parasites. However, the real symptoms tend to appear after the incubation period ends. The incubation period of the different strains is as follows:
- P.Falciparum: 9-14 Days
- P. Vivax and P.Ovale: 12-18 Days
- P.Malariae: 18-40 Days
- P.Knowlesi: 11-12 Days
Common symptoms tend to appear within a period of one week. The symptoms can differ depending on the general health of the infected person and on the basis of the parasite with which the person has been infected.
Some of the most common symptoms and signs of Malaria are as follows:
- High and persistent fever
- Increased sense of fatigue
- Nausea and vomiting
The symptoms of the disease tend to occur in cycles. Between the periods of the fever the episodes of the symptoms can occur. The reason behind the cyclic symptoms is the cyclic life cycle of the parasites. They develop, they reproduce, they are released within the RBC’s and the liver cells of the person. The presence of this cycle is another one of the major symptoms of Malaria.
Apart from the above mentioned symptoms, some of the other signs are as follows:
- Dry and non productive cough
- Muscle and back pain
- Enlargement of the spleen
In some of the rare cases when the disease is not treated at time, it can lead to the impairment of the brain and the spinal cord along with frequent seizures. Infection caused due to the parasite P. Falciparum is more life threatening as compared to other parasites. It is very crucial to visit your doctor as soon as you experience any or more than one of these symptoms.
Cerebral Malaria is one of the most severe neurological complications which is caused due to Plasmodium Falciparum. Around 5, 75,000 people all over the world are affected by this condition annually. Patients developing this condition are at a high risk of contracting neurological as well as cognitive impairments.
The rate of morality is very high due to this kind of infection. In the tropical countries, P. Falciparum is one of the leading causes for death amongst children.
Some of the major symptoms of Cerebral Malaria are as follows:
- Impairing of consciousness
- Coma (In severe cases)
- Swelling in the brain
- Changes in the retina
- Fever, headaches and nausea
If proper treatment is not provided, then Cerebral Malaria can prove to be fatal for children. Around 15-20% people suffering from this condition die. The risk factors of the disease contain repeated seizures, prolonged and deep coma as well as hyperglycemias and hypertension.
Malaria Prophylaxis: Treatment for Malaria
Malaria Prophylaxis is the treatment for malaria. Several medications and vaccines are under development for the treatment of the disease. The basic steps for Malaria Prophylaxis are as follows:
o Awareness of the risks for contracting Malaria
o Reducing the chances of being bitten by the anopheles mosquito
o Diagnosis as well as the treatment in order to reduce the complications of the disease.
- Awareness of the risk:
Risk assessment should be done always. If you are travelling to a region where malaria is rampant, make sure that you know your geographical location. Expert advice should be taken before travelling. Areas such as Africa, South America and Asia are the major zones for malaria epidemic. Pregnant women, asplenic patients, patients suffering from HIV AIDS as well as children are at a higher risk of contracting the disease.
- Avoiding the Bites:
Avoiding the bites is very important. Chemoprophylaxis is not longer the most credible solution as a lot of mosquitoes have developed drug resistant strains. The bites occur mostly between the time of dusk and dawn. It is recommended to keep the arms and legs covered after the sunset. Picaridin is one of the most effective drugs for resisting the mosquito bites. Using the sprays and vaporisers is recommended. It is recommended to sleep inside. If in case you are sleeping outside, try using mosquito repellent nets.
Despite Chemoprophylaxis, infections tend to occur. Before entering an area suspected with Malaria infection, it is recommended to start the drug regimen one week before. This should continue for up to four weeks after the return. The suggestion of a specialist should be taken before taking any medication. Some of the most common medications used all over the world to combat Malaria are Choloroquine, Proguanil, Mefloquine, Malarone and Doxycycline.
- Diagnosis and Treatment:
Prompt action and treatment should be provided to a person once he has been diagnosed with Malaria. Malaria is totally treatable and can be prevented. Treatment reduces the chance of spreading the infection from one person to the other. Treatment is done with the perspective of removing the Parasite Plasmodium entirely from the bloodstream.
The diagnosis of the disease can be done using either microscopy or rapid diagnostic test (RDT).
Artemisinin based combination therapies (ACT’s) are best used for the treatment of malaria in the initial stages. However ACT’s should not be prescribed to the person orally as it promotes the development of artemisinin resistance in patients. Also, fixed doses need to be provided to the patients by a doctor rather than loose prescriptions.
In case of severe malaria, Inject able Artesunate is best combined with ACT orally for the prevention of the disease.
A vaccine is generally a product which is provided in order to prevent the disease from occurring. It has been designed in order to develop the body’s immune system to develop the responses in order to fight against the disease.
Though malaria vaccine can be easily created, creating a vaccine to fight against a parasite has been done. Also, developing a vaccine for malaria can prove to be a huge challenge. There will be different factors to look into, such as checking the effectiveness, safety as well as affordability of the vaccine. The World Health Organization has gone in to ensure that by the year 2015, it will be possible to make a headstrong decision towards creating a vaccine for malaria.
The malaria vaccines which are being developed are done with the aim to minimize the chances of resistance against the disease by the parasite. It is theoretically possible for the microbes to develop resistance against a vaccine. However, on a global platform this is not a huge problem.