Reoccurring Malaria

by

QUESTION

Can malaria reoccur year after year from a single infection? I have been told that it comes back every year by many people. I have had malaria once and it never came back after successful treatment. My thinking is that once the parasite has been eliminated from the system it is gone unless you get bitten again.

ANSWER

There are several different types of malaria that infect humans, and two of these species (Plasmodium ovale and Plasmodium vivax) can recur from year to year after a single infection.

The way it happens is that these types of malaria are able to form dormant life stages which hide in the liver. Most malaria medication only targets the blood stage form of malaria, and so these liver stages escape being killed by the medication, and can survive for long periods of time without the patient knowing about them. Then, at some point later (no one knows exactly what triggers the relapse—there is evidence that infection with other forms of malaria can instigate relapse, or being bitten by mosquitoes, or even just the climate), the liver stages activate again and re-enter the blood stream, which causes a renewal of symptoms.

It is possible to prevent these relapses—there is one type of medication, called primaquine, which is able to kill the dormant liver stages and thus completely clear the patient of malaria. However, it is important to talk to your doctor before taking primaquine, as it is not suitable for some people (especially those with G6DP deficiency).

Apart from these two types of malaria, the other three forms that infect people (P. falciparum, P. malariae and P. knowlesi) cannot reoccur in the same way as described above – if you have been infected with one of these, and then been successfully treated, you cannot get the disease again unless you are bitten by another infected mosquito.

Malaria Prevention

by

QUESTION

What are the ways in which you can prevent yourself from being infected with malaria?

ANSWER

Malaria prevention consists of a combination of mosquito avoidance measures (since malaria is transmitted by infected mosquitoes) and chemoprophylaxis (medication to prevent the establishment of malaria in your body, if you do get bitten). Although very efficacious, none of the recommended interventions are 100% effective.

Mosquito Avoidance Measures

  • Because of the nocturnal feeding habits of Anopheles mosquitoes, malaria transmission occurs primarily between dusk and dawn.
  • Contact with mosquitoes can be reduced by remaining in well-screened areas, using mosquito bed nets (preferably insecticide-treated nets), using a pyrethroid-containing flying-insect spray in living and sleeping areas during evening and nighttime hours, and wearing clothes that cover most of the body.
  • All travelers should use an effective mosquito repellent.
  • The most effective repellent against a wide range of vectors is DEET (N,N-diethylmetatoluamide), an ingredient in many commercially available insect repellents. The actual concentration of DEET varies widely among repellents. DEET formulations as high as 50% are recommended for both adults and children older than 2 months of age (see the Protection Against Mosquitoes, Ticks, and Other Insects and Arthropods section later in this chapter). DEET should be applied to the exposed parts of the skin when mosquitoes are likely to be present.
  • In addition to using a topical insect repellent, a permethrin-containing product may be applied to bed nets and clothing for additional protection against mosquitoes.

Chemoprophylaxis

      • All currently recommended primary chemoprophylaxis regimens involve taking a medicine before travel, during travel, and for a period of time after leaving the malaria endemic area. Beginning the drug before travel allows the antimalarial agent to be in the blood before the traveler is exposed to malaria parasites.
      • Presumptive antirelapse therapy (also known as terminal prophylaxis) uses a medication towards the end of the exposure period (or immediately thereafter) to prevent relapses or delayed-onset clinical presentations of malaria caused by hypnozoites (dormant liver stages) of P. vivax or P. ovale. Because most malarious areas of the world (except the Caribbean) have at least one species of relapsing malaria, travelers to these areas have some risk for acquiring either P. vivax or P. ovale, although the actual risk for an individual traveler is difficult to define. Presumptive anti-relapse therapy is generally indicated only for persons who have had prolonged exposure in malaria-endemic areas (e.g., missionaries, volunteers).
      • In choosing an appropriate chemoprophylactic regimen before travel, the traveler and the health-care provider should consider several factors. The travel itinerary should be reviewed in detail and compared with the information on where malaria transmission occurs within a given country to determine whether the traveler will actually be traveling in a part of the country where malaria occurs and if significant antimalarial drug resistance has been reported in that location.
      • The resistance of P. falciparum to chloroquine has been confirmed in all areas with P. falciparum malaria except the Caribbean, Central America west of the Panama Canal, and some countries in the Middle East. In addition, resistance to sulfadoxine–pyrimethamine (e.g., Fansidar) is widespread in the Amazon River Basin area of South America, much of Southeast Asia, other parts of Asia, and in large parts of Africa. Resistance to mefloquine has been confirmed on the borders of Thailand with Burma (Myanmar) and Cambodia, in the western provinces of Cambodia, in the eastern states of Burma (Myanmar), on the border between Burma and China, along the borders of Laos and Burma, and the adjacent parts of the Thailand–Cambodia border, as well as in southern Vietnam.
      • Additional factors to consider are the patient’s other medical conditions, medications being taken (to assess potential drug–drug interactions), the cost of the medicines, and the potential side effects.

The medications recommended for chemoprophylaxis of malaria may also be available at overseas destinations. However, combinations of these medications and additional drugs that are not recommended may be commonly prescribed and used in other countries. Travelers should be strongly discouraged from obtaining chemoprophylactic medications while abroad. The quality of these products is not known, and they may not be protective and may be dangerous. These medications may have been produced by substandard manufacturing practices, may be counterfeit, or may contain contaminants. Additional information on this topic can be found in an FDA document

Purchasing Medications Outside the United States.

Taking other Pills with Malaria Medication

by

QUESTION

If Its okay to take ACE DIET supplements if Im taking MALARIA pills?

ANSWER

If you are taking natural ACE supplement pills, then the active ingredients are usually caffeine, cocoa and maybe green tea. None of these compounds has any observed interaction with malaria pills, so they should be safe to take at the same time. However, without knowing exactly which type of ACE pills and malaria pills you are taking, it is impossible to say for certain. You should consult your physician for specific advice on this matter.

Wha socio economic and enviromental conditions contribute to malaria?

by

QUESTION

what socio-economic and environmental conditions contribute malaria?

ANSWER

Malaria transmission requires the presence of Anopheles mosquitoes; as such, conditions which favor the growth and persistence of these mosquitoes will also be hotspots for malaria transmission, provided the climate is also sufficiently warm for the development of the parasite within the mosquito.

Rural areas without sophisticated water and sanitation systems often utilize streams or ponds for everyday water needs; if these produce stagnant patches of water, they can be an ideal location for the development of mosquito larvae. Similarly, if rural farmers dig canals or ditches to irrigate their fields, these can become breeding areas. Urban areas tend to have less standing water, apart from cisterns, so in many cases transmission is less prevalent in urbanized locations. As a further socio-economic factor, preventing mosquitoes from entering the house and biting people is key way to prevent infection. Rich people in malarial areas may be more able to have fully screened houses, possibly even with air-conditioning, which will prevent mosquitoes from establishing in the house. They may also be more likely to have access to a long-lasting insecticide treated bednet, which further reduces mosquito bites, and also access to accurate diagnostic screening and treatment, if they do happen to get infected.

All of these factors contribute to making malaria burden highest in some of the world’s poorest areas, with the highest levels of mortality in sub-Saharan Africa.

Herbal Treatment for Malaria

by

QUESTION

Can any form of malaria be treated by herbs or plants, and how long does it take to recover from malaria?

ANSWER

Actually, two of the most important kinds of anti-malarial medication are derived by substances found naturally in plants, though they need to be processed in certain ways before the full pharmaceutical effect is felt.

Quinine, administered intravenously, is currently the first-line treatment for complicated malaria (i.e. when the patient has a history of high fever, plus additional severe symptoms such as impaired consciousness). It is derived from the bark of trees of the genus Cinchona, which are native to the tropical rainforests of western South America. Long known to native populations for its medicinal properties, it became known to Europeans in the early 17th century when the Countess of Chinchón, the wife of the viceroy of Peru at the time, was cured by it, having been suffering from what was likely malaria.

Similarly, artemisinin, currently used in combination with other anti-malarial compounds as the first-line treatment against non-complicated malaria (these combinations are known as artemisinin-based combination therapies, or ACTs), is derived from wormwood, a shrub native to Asia but now found throughout the world. As with the Cinchona trees, traditional healers in China had used wormwood to treat fever for thousands of years, but its use had been forgotten in modern times, until its rediscovery in the 1970s. Nowadays, artemisinin is not recommended for treatment alone, as it is feared this will lead to resistance developing, and so it is only used in the combination therapies described above.

If treated promptly, and with the correct form of medication, recovery from malaria can take only a few days. If not, recovery can take much longer (even up to weeks), and in the case of P. falciparum malaria, the most deadly kind, the infection can become life threatening in only a day or two. P. knowlesi (found in parts of south-east Asia), though less fatal than P. falciparum, can also become severe rapidly, and so prompt treatment is especially necessary for these two kinds of malaria.

Distribution of Malaria

by

QUESTION

Where does malaria mostly take place?

ANSWER

Malaria is mainly transmitted in tropical regions of the world; while some transmission does occur outside of the tropics, it tends to be seasonal in these areas (i.e. usually only during periods of high temperature/high rainfall). Within the tropics, malaria is found on all continents, though the highest number of cases is in Africa, which is also where over 90% of deaths due to malaria occur (of these, most are children under the age of 5). Outside Africa, the next highest levels of malaria are in India and south-east Asia and the western Pacific (such as Papua New Guinea).

Malaria Beliefs

by

QUESTION

How do beliefs and attitude affect the spread, treatment and prevention of malaria?

ANSWER

Accurate information and knowledge about how malaria is transmitted, diagnosed and treated is crucial to controlling the disease, for the general public living in malarial areas, travelers to these areas and health professionals. For example, many travelers are unaware that their destination is in a malaria transmission zone, so they do not take appropriate preventive precautions. Similarly, many travelers I have met believe that if they have had malaria once, they are immune and cannot get reinfected, so don’t bother protecting themselves from mosquitoes – this is not true, and they are inadvertently putting themselves at great risk.

In terms of endemic areas, the focus is on educating people about day-to-day preventive measures, such as sleeping under long-lasting insecticide treated bednets and indoor residual spraying. Educational campaigns that focus on simple, straightforward ways to prevent malaria are more likely to influence people’s attitudes and lead to better malaria control. Similarly, teaching people to seek accurate diagnosis and then ensuring they have appropriate treatment is an important step.

In some places, people feel they cannot afford to visit a doctor or clinic, or would rather place their trust in a traditional healer or healing herbs; since the most effective medications against malaria are treatments such as artemisinin-based combination therapies, which are available through official health sources such as clinics, believing in traditional medicine can lead to the malaria infection becoming very severe, and even resulting in death. As such, another component to control is making sure that medical services such as clinics are easily accessible even for the poorest people, provide good health care and are affordable.

Mosquito Types

by

QUESTION

How many types of mosquito are there?

ANSWER

There are over 3,500 species of mosquito! However, most of these do not transmit any diseases to humans. Mosquitoes are usually divided into two sub-families, the Anophelinae and the Culicinae. The latter group consists of about 40 genera, including Culex and Aedes, which contain some species that transmit diseases to humans (such as yellow fever, dengue fever and West Nile). The former contains the genus Anopheles, which are the mosquitoes that transmit malaria. There are about 460 described species of Anopheles mosquito, of which about 100 can transmit malaria, though the vast bulk of transmission is usually limited to about 30 species.

Malaria Drugs Side Effects

by

QUESTION

I was affected by malaria 5 months back. I am feeling tiered and weakness and heart trembling symptoms.

Any suggestions to overcome weakness?

ANSWER

Your fatigue is probably not caused by the treatment—one of the potential residual effects of malaria infection is iron deficiency, which can lead to anaemia, and this can cause tiredness. Eating iron-rich foods or asking your doctor about iron supplements might help if indeed you find your iron levels are too low. Recovery from any illness can sometimes take a long time, and getting plenty of rest, eating well and keeping well hydrated will all help you to regain your strength.

If you have recently taken malaria medication, perhaps you would be willing to spend a few minutes to take our Malaria Medication Side Effects Survey? We are very interested in hearing about the experiences of people who have taken different types of malaria medication, and particularly any side effects they have experienced. The survey should only take a few minutes and will be anonymous; we will publish the results on the website for you to see. Many thanks for your assistance!

Symtoms of Malaria

by

QUESTION

Please tell me the symptoms of malaria.

ANSWER

Symptoms of malaria include fever and flu-like illness, including shaking chills, headache, muscle aches, and tiredness. Due to the way in which the malaria parasite reproduces in the human body, fevers occurring in a cyclical fashion (i.e. high fever one day, no fever the next day, then recurrence of fever on the third or fourth day, depending on the type of malaria) are a characteristic symptom of malaria, but may not be present in all cases. 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. When blood supply to the brain is disrupted during malarial infection, the resulting condition, characterised by seizures, mental confusion, coma, and death, is known as “cerebral malaria”, and is associated with Plasmodium falciparum, the most deadly form of malaria.

Please check your article: Symptoms and Causes of Malaria