Malaria in the Brain

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QUESTION

I would like to know how dangerous is malaria in the brain?

ANSWER

Only a certain kind of malaria, Plasmodium falciparum, is usually associated with causing problems in the brain. The P. falciparum parasite infects red blood cells and changes their surface structure, causing them to become “sticky”. These sticky red blood cells become lodged in the small blood vessels that flow through organs, causing blockages and reducing oxygen flow.

When this process occurs in the brain, the result is called “cerebral malaria”, and can result in impaired consciousness, coma and even death. As such, once malaria-infected blood passes into the brain, it can be very dangerous. Luckily, however, if people are diagnosed promptly and given treatment, it is usually possible to stop the progression of P. falciparum malaria before it enters the brain, allowing for a swift and uncomplicated recovery.

Malaria Muscle Aches

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QUESTION

I am someone who has traveled to malaria-infected areas in the past and will do so again in the future. I also happen to have a form of musculr dystrophy (myotonic dystrophy type II) that, among other things, causes me to experience frequent episodes of muscular pain. Thus, the mere presence of muscle pain, in my particular case, can tell little about whether I might have malaria.

Though I do understand there are several other symptoms to look for, I also would still like to have a better understanding of what malarial muscle aches tend to feel like in the hope that this information could perhaps help me distinguish this particular form of muscle pain from the other muscle pains I already experience. For example, I have also occasionally experienced pulled muscles, or muscles that simply were overused during a recent, too prolonged session of resistance training. Thus I am familiar with how these feel and how they differ from the more usual pains caused by my muscular dystrophy. This helps me recognize what is likely causing a particular muscle pain on a particular occasion.

Can you describe malarial “muscle aches” in more detail? For example, which muscles are affected? (The muscular dystrophy tends to cause pain more often in certain muscles while others are more rarely, or not at all, affected … so this information alone could be helpful). Does the ache tend to stay in one set of muscles, or does it move around, hurting one set of muscles on Monday morning and another on Monday night, etc.? Is it a persistent, steady pain (hurting as much on Wednesday as it did on Tuesday) or does it fluctuate? Is it a sharp pain? Dull? Throbbing? What? Does moving or using the aching muscle make it hurt more? Does it come with joint pain, or not? What?

I do, of course, intend to educate myself further about malaria and am already aware of other symptoms that are more helpful for me to be aware of. (Headaches is NOT among these since I have so many of those also, but some of the other symptoms I’ve read are far more unusual for me and thus more helpful in signaling to me the possibility that I’m actually sick and not just having a “bad pain day”) But knowing more about typical malarial muscle pain would help give me an additional data point to consider.

Your assistance will be much appreciated.

ANSWER

I have checked in with one of our medical advisors here at MALARIA.com and this is what he has replied:

Unfortunately, there is no useful characterization of muscle aches associated with malaria. Malaria is not a subtle disease that needs to be detected by characterizing the location or quality of muscle pains.  The main symptoms of malaria are high fever and shivering/shaking chills.  The presence of these symptoms should prompt an evaluation for malaria.  That being said, it should not be an issue if the person takes malaria chemoprophylaxis and uses appropriate mosquito avoidance measures.

Hope that helps!

Blood Transfusion and Malaria

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QUESTION

Do people need to receive blood if they get malaria?

ANSWER

Usually not. Most cases of malaria are uncomplicated and are treated using oral antibiotics. However, if the disease progresses sufficiently and the patient is not promptly treated, it can become more severe. This is particularly true for infection with Plasmodium falciparum malaria, which can lead to impaired consciousness, coma and even death. In these severe cases, maintaining the patient’s balance of fluids, electrolytes and blood pressure is crucial, and so administration of plasma or blood might be required.

Regular Fever after Malaria

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QUESTION

I am from Indore (India). I was affected by malaria positive vivax. My doctor give me some tablet but soon my fever is gone. After few months my fever is come back and fever is repeated every time but does not leave for long time. Fever will repeated after few hours. What can I do?

ANSWER

It sounds like you might have recurring P. vivax malaria. This is when the malaria is treated in the blood stage of infection, but some parasites are able to remain dormant in the liver, and come back and cause disease later on. You should talk to your doctor about taking primaquine—this is a drug that can kill the liver stages and thus prevent future relapses of infection. However, you should be tested for G6DP deficiency first. Also, when you experience a recurrence of the fever, you should still go to your doctor for diagnosis, to confirm that you do have malaria and not another disease. The symptoms of malaria are very generic and can be mistaken for many other things.

vomiting

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QUESTION

Is it normal to be vomiting after taking malaria tablets?

ANSWER

Side effects are generally rare with most malaria medication, though vomiting is one of the more common side effects that have been reported. We at MALARIA.com are very interested in hearing about people’s experiences with malaria medication, so please take our malaria survey. Many thanks for your time!

 

Malaria Prophylaxis in Pakistan

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QUESTION

Do I need antimalarials if i am returning to my home country in pakistan after two years?

ANSWER

That depends on where you will be going in Pakistan and how long you are planning on staying. Malaria is a risk at all areas under 2,500m of altitude. However, antimalarials are not recommended to be taken on a long-term basis, so if you are relocating home permanently and will be in an area at risk of malaria transmission, you should look into other preventative measures. This includes sleeping under a long-lasting insecticide-treated bednet at night, which prevents infected mosquitoes from biting you, and also potentially spraying indoors to kill mosquitoes. Making sure all rooms are well-screened can also keep mosquitoes out, and wearing long-sleeved clothing and insect repellent on exposed skin will further reduce bites. If you suspect you might have malaria (for example if you experience high fever, particularly coming in cycles interspersed with chills), you should immediately visit a doctor or clinic to test for malaria, so you can receive prompt and accurate treatment.

If you are staying in Pakistan for a short period of time (< 6 weeks) you could certainly consider taking an anti-malarial drug to prevent malaria. Doxycycline, mefloquine (sold as Lariam) and atovaquone-proguanil (sold as Malarone) are all recommended as appropriate prophylactic medications against malaria in Pakistan.

What countries have malaria?

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QUESTION

In which countries can it be found?

ANSWER

Malaria is found in many parts of Africa, Latin America, Asia, and Oceania. The exact distribution depends on climatic variables (namely heat and sufficient rainfall, for the development of the mosquitoes which transmit malaria) and also how successful a particular country or region has been at controlling malaria.

For example, malaria was once found in parts of the U.S. and Europe, but successful campaigns to control mosquitoes and treat cases led to elimination of transmission. The same is true in other parts of the world; for example, in Malaysia, transmission is successfully controlled in Kuala Lumpur, but malaria can still be found in many parts of the surrounding countryside.

Please visit the CDC website for an interactive map of malaria distribution around the world.

Is malaria a problem for a tourist in Guyana?

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QUESTION

Is malaria a problem for a tourist to Guyana?

ANSWER

Yes, malaria is something you should be aware of when travelling to Guyana. Transmission occurs in all areas under 900m in Guyana, including Georgetown. If you are visiting these areas, you should consider taking prophylactic medication to prevent malaria, such as atovaquone-proguanil (sold as Malarone), doxycycline or mefloquine (Lariam). You should also consider other preventative measures while you are there, such as sleeping under a bednet, wearing long-sleeved clothing (especially in the evenings and at night) and covering exposed skin with insect repellent.

Is there Malaria in United Arab Emirates (UAE)?

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QUESTION

Is the UAE malaria free?

ANSWER

Yes—the UAE is not considered a transmission area for malaria. However, other insect-borne diseases can occur in this region, such as West Nile virus, so while in the UAE it is still worth taking preventative measures against insect bites, such as wearing long-sleeved clothing and using insect repellent on exposed skin.

Malaria in Namibia or South Africa

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QUESTION

Is there a risk of catching malaria in Namibia or South Africa

ANSWER

Yes. According to the CDC, malaria is present in the following areas of Namibia: Kunene, Ohangwena, Okavango, Omaheke, Omusati, Oshana, Oshikoto, and Otjozondjupa and the Caprivi Strip. In addition, malaria is present in South Africa in northeastern KwaZulu-Natal Province as far south as the Tugela River, Limpopo (Northern) Province, and Mpumalanga Province. It is also present in Kruger National Park.

If you are visiting these areas, it is recommended you take prophylactic medication (such as doxycycline, mefloquine or atovaquone-proguanil) and sleep under a bednet. Other preventative measures against mosquito bites, such as wearing long-sleeved clothing and insecticide on exposed skin (especially in the evenings and at night) are also recommended.