by Malaria Q&A
QUESTION
How can I protect myself from being infected with malaria?
ANSWER
There are many ways to prevent from getting infected with malaria. Some methods are more appropriate if you live in a malarial area, others are more for travellers to malarial areas, who are not staying long term. MALARIA.com has a comprehensive page dedicating to malaria prevention and protection.
by Malaria Q&A
QUESTION
What is the dosage for a toddler who is taking Lumartem tablet?
ANSWER
Lumartem, like many anti-malarial drugs, is dosed by weight. Therefore if your toddler weights 5-15kg, s/he should be give one tablet (containing 20mg of artemether and 120mg of lumefantrine) immediately after diagnosis of malaria, then another tablet 8 hours after the first one, then one tablet every 12 hours after that until the end of the 3rd day (a total of 6 tablets, taken over 6 doses).
For children weighing 15-25kg, the timing of the doses is the same, but each time, give two tablets. Try not to miss a dose, but if you do, give the child the missed dose as soon as you remember, then wait the prescribed time interval (12 hours, usually) before giving the next one. Do not give a double dose.
by Malaria Q&A
QUESTION
I just read the CDC recommended medicines for preventing malaria and I am confused. It gives the pros and cons for taking one drug over another. My husband and I are in excellent health, we need our td boosters. Our 15 year old is current in his vaccinations. We will be in D.R. for 2.5 weeks near Jarabacoa then Rio San Juan. We will be on a missionary trip. What medicine should be take in your opinion before hand?
ANSWER
Apart from some basic differences, particularly regarding which forms of malaria they are effective and against, and in what areas of the world, the choice of which anti-malarial to take mostly comes down to personal preferences. So, for example, in most of Africa, malaria is resistant to chloroquine, so this drug is not recommended for travellers; conversely, in parts of Thailand, malaria is resistant to mefloquine, so likewise, if travelling to those areas, you would need to pick another drug.
Having said that, in the Dominican Republic the malaria is sensitive to all forms of anti-malarial drugs, so you don’t have to worry about that. Between the four main types of drug you can take (atovaquone-proguanil, doxycycline, mefloquine and chloroquine), there are significant differences in price, frequency and duration of taking the tablets and side effects, all of which may influence your decision to take one over another. They are all roughly equal in terms of their efficacy in preventing malaria, apart from when resistance is an issue, as I’ve mentioned.
Of the four, chloroquine and mefloquine are taken weekly, while atovaquone-proguanil (often sold as Malarone) and doxycycline are taken daily. Some people prefer the convenience of only having to take a pill every week, but the disadvantage is that these both have to be started 2 weeks before you travel, whereas the daily medications can be started the day before you leave. While Malarone only needs to be taken for one week after returning from your trip, the others should be taken for a full four weeks, to ensure that malaria does not surface once you’re back.
All have some reported side effects, but in my experience, Malarone has the fewest and the most mild, though some people report upset stomachs and disturbed sleep. Chloroquine also has some potential gastrointestinal side effects and can also produce itching, which is a particularly common side effect in people of African descent. The tablets have a metallic taste which some people find unpleasant.
Doxycycline is also an antibiotic, which means it can also help prevent other infections while travelling, though one of its common side effects is sun sensitivity, which may make it less suitable for travelling in tropical areas (personally I have not experienced this side effect, though I have known many people who have).
Mefloquine (sold as Lariam) is not recommended for people with a history of mental illness, and is known to have psychiatric side effects, including nightmares, hallucinations and even altered behavior (again, my whole family took Lariam during one trip, and no one experienced any such side effects, but you should be aware of the possibilities).
Another important factor to consider is price: doxycycline is usually the cheapest drug, and Malarone the most expensive (could be as much as $100 for each of you, for enough to cover the 2.5 week trip, plus a week of tablets once you get back), with the others somewhere in between.
Again, ultimately the choice usually comes down to what factors are important to you and your personal preference. I tend to pay the extra for Malarone since I prefer the convenience of starting the pills right before I leave, and only taking them for a week when I return. Furthermore, when I am away, I am usually working outside, and so would rather not risk the potential sun sensitivity side effect of doxycycline. You should also talk with your doctor about what is usually available in your area from local pharmacies, as they may not carry the full selection of choices.
by Malaria Q&A
QUESTION
How many people have died from malaria since 1966?
ANSWER
Accurate counts of the number of people who die from malaria are notoriously hard to make, since often the infection goes diagnosed, or the cause of death is not reported. However, the World Health Organization has estimated that until recently, about 1 million died each year from malaria. So, without taking into account changes in population size or other demographic factors, that means roughly 45 million people have died from malaria since the mid 1960s.
In the last few years, large-scale coordinated global efforts as well as numerous grass-roots campaigns have sought to reduce the number of deaths from malaria, mainly through improved preventive methods, education, diagnosis and treatment availability. As such, in 2010, it was estimated that deaths were down to about 700,000 per year, though that figure is contested by some, who argue it should be far higher. Organizations such as Malaria No More and the Roll Back Malaria consortium seek to prevent all deaths from malaria by the year 2015, and are working tirelessly to achieve that target.
by Malaria Q&A
QUESTION
My body is getting hotter after taking artesunate and mtivitamen tablet, the pain subsides, but later in the evening my body starts getting hotter, I have taken almost four artesunate, yet the body pain and headache refuse to go, pls sir is it malaria or what.
ANSWER
Unfortunately the symptoms of malaria are quite general, and just having a fever could be a sign of malaria but also of many other diseases. You should go to a doctor or clinic to have a blood test—there, they will take some of your blood and look at it under the microscope to determine whether you have malaria parasites in your blood. If you do, they will give you appropriate treatment—it is actually not recommended to take artesunate by itself, and rather it should be taken together with a secondary anti-malarial drug, in a combination known as an artemisinin-based combination therapy (ACT).
Common forms of ACTs available in Africa include artemether-lumefantrine (sold as Alu, Lonart or Coartem) and dihydroartemisinin-piperaquine (sold as Artekin or Duo-Cotecxin). Artesunate comes in combination with amodiaquine, and is often abbreviated as ASAQ.
If you do not get properly diagnosed in a medical facility, you risk treating yourself with unnecessary drugs if in fact you actually have another infection, or you might find you are giving yourself the wrong type of treatment for your malaria infection.
by Malaria Q&A
QUESTION
where did malaria come from?
ANSWER
Malaria is a disease caused by a single-celled parasite called Plasmodium. There are many species of Plasmodium, which infect many other animals as well as humans. The types of malaria which infect humans probably evolved from similar Plasmodium species in monkeys and apes; for example, P. vivax is closely related to several species of malaria that infect macaque monkeys in south-east Asia, while P. falciparum, the most severe and deadly kind of malaria, probably evolved from similar infections in chimpanzees and gorillas in central Africa. This transition from other primates to humans occurred many thousands of years ago; further back in time, the types of Plasmodium which infect mammals (rodents can also be infected with Plasmodium) are thought to have jumped over from Plasmodium species which infect birds and reptiles. Even before that, Plasmodium itself seems to have evolved from other types of blood-borne parasites which infect birds and reptiles.
by Malaria Q&A
QUESTION
I was unconscious and fell to the ground. I went to the hospital and the doctor said it was malaria. He gave me malareich which was one dose for the treatment. I want find out if that is the effective medication for this malaria and if the symptoms will never happen again. The one happened when i was a kid,the second happened when i was 21 yrs and now am 28 yrs and it happened again.
ANSWER
Malareich is a known anti-malarial drug, which consists of sulfadoxine-pyrimethamine, and is taken as a single dose. The World Health Organization however no longer recommends sulfadoxine-pyrimethamine drugs as first-line anti-malarials,
preferring people instead to take artemisinin-based combination therapies (ACTs) such as Lonart or Coartem. Moreover,
sulfadoxine-pyrimethamines are not very effective against some types of malaria, namely Plasmodium vivax, so shouldn’t be given without a positive diagnosis of Plasmodium falciparum malaria.
by Malaria Q&A
QUESTION
What are the symptoms of Malaria?
ANSWER
Symptoms of malaria include fever and flu-like illness, including shaking chills, headache, muscle aches, and tiredness. Nausea, vomiting, and diarrhea may also occur. Malaria may cause anemia and jaundice (yellow coloring of the skin and eyes) because of the loss of red blood cells. Symptoms usually appear between 10 and 15 days after the mosquito bite. If not treated, malaria can quickly become life-threatening by disrupting the blood supply to vital organs. Infection with one type of malaria, Plasmodium falciparum, if not promptly treated, may cause kidney failure, seizures, mental confusion, coma, and death. In many parts of the world, the parasites have developed resistance to a number of malaria medicines.
For most people, symptoms begin 10 days to 4 weeks after infection, although a person may feel ill as early as 7 days or as late as 1 year later. Two kinds of malaria, P. vivax and P. ovale, can occur again (relapsing malaria). In P. vivax and P. ovale infections, some parasites can remain dormant in the liver for several months up to about 4 years after a person is bitten by an infected mosquito. When these parasites come out of hibernation and begin invading red blood cells (“relapse”), the person will become sick.
Infection with malaria parasites may result in a wide variety of symptoms, ranging from absent or very mild symptoms to severe disease and even death. Malaria disease can be categorized as uncomplicated or severe/complicated. In general, malaria is a curable disease if diagnosed and treated promptly and correctly.
by Malaria Q&A
QUESTION
could you please let me know, whether or not a malaria prophylaxe injection is necessary for a 3-weeks trip by car in Namibia, starting mid August.
ANSWER
It depends on where you are going in Namibia. According to the US Centers for Disease Control, malaria is transmitted in Namibia in the provinces of Kunene, Ohangwena, Okavango, Omaheke, Omusati, Oshana, Oshikoto, and Otjozondjupa and in the Caprivi Strip. As such, if you are travelling to any of these areas, you should consider taking medication to prevent malaria. Three types of medication are considered equally effective in these regions: atovaquone-proguanil (Malarone), mefloquine (Lariam) and doxycycline. Which one you decide to take is mainly a matter of personal preference, based on details such as how often you will need to take a tablet (every day for Malarone and doxy, once a week for Lariam), how long you want to take the medication (Malarone is started the day before your trip, and should be taken for a week after, doxy is also started 1-2 days before travelling but must be taken for 4 weeks after returning and Lariam is started 2 weeks before travelling and for 4 weeks afterwards) and price (Malarone is the most expensive, and doxy usually the cheapest). In addition, each has different potential side effects (Malarone usually has the fewest; doxy can result in sun sensitivity, and Lariam may have psychiatric side effects, and is not recommended for anyone with a history of mental illness).
by Malaria Q&A
QUESTION
What is the safest antimalarial drug to be used by a pregnant woman in her second trimester?
ANSWER
With regards to treating malaria, intravenous artesunate (or quinine, if artesunate is not available) should be used for the treatment of severe/complicated Plasmodium falciparum malaria. Signs of severe and/or complicated malaria include impaired consciousness, organ failure, abnormal bleeding, hypoglycemia, severe anemia and/or inability to ingest medication orally. Treatment for uncomplicated malaria (where the above signs are absent) in pregnant women is usually chloroquine for P. vivax, P. ovale, P. knowlesi and P. malariae, as well as for P. falciparum if there are no reports of this parasite being resistant to chloroquine in the area. In places where P. falciparum is resistant to chloroquine, quinine and clindamycin should be used to treat this parasite in pregnant women.
As for preventative anti-malarials (chemoprophylaxis), if a pregnant woman is travelling to an area where only P. vivax, P. ovale, P. knowlesi, P. malariae or chloroquine-sensitive P. falciparum is transmitted, then she should take chloroquine to prevent malaria. In areas where P. falciparum is resistant to chloroquine, mefloquine is also suitable during pregnancy. Note that in some areas of south-east Asia, there are areas where P. falciparum is resistant to mefloquine, which may prevent its suitability as a prophylactic in this region. Preventing malaria during pregnancy is crucial, since the mother, particularly if it is her first baby, is especially vulnerable to the parasite. Moreover, malaria can have a negative impact on the fetus.