Causes of Malaria

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QUESTION

What are the causes of malaria?

ANSWER

Malaria is caused by a parasite called Plasmodium, which is transmitted via the bites of infected mosquitoes. In the human body, the parasites multiply in the liver, and then infect red blood cells. Usually, people get malaria by being bitten by an infective female Anopheles mosquito.

Only Anopheles mosquitoes can transmit malaria and they must have been infected through a previous blood meal taken on an infected person. When a mosquito bites an infected person, a small amount of blood is taken in which contains microscopic malaria parasites. About 1 week later, when the mosquito takes its next blood meal, these parasites mix with the mosquito’s saliva and are injected into the person being bitten.

Following the infective bite by the Anopheles mosquito, a period of time (the “incubation period”) goes by before the first symptoms appear. The incubation period in most cases varies from 7 to 30 days. The shorter periods are observed most frequently with P. falciparum and the longer ones with P. malariae.

Because the malaria parasite is found in red blood cells of an infected person, malaria can also be transmitted through blood transfusion, organ transplant, or the shared use of needles or syringes contaminated with blood. Malaria may also be transmitted from a mother to her unborn infant before or during delivery (“congenital” malaria).


Quinine Side Effects

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QUESTION

What are the side effects of quinine?

ANSWER

The main side effect of quinine, in therapeutic doses, is cinchonism or quinism. This is a condition associated with a number of symptoms, including flushed/sweaty skin, tinnitus, confusion, headaches, and more.

Mild cinchonism should not be a reason to cease treatment with quinine, however. If injected into a nerve, quinine can cause paralysis, and is an extremely potent poison if overdosed. In some cases, quinine can lead to constipation, erectile dysfunction and/or diarrhea. There are few side effects associated with oral quinine.

If you have taken medications for malaria, please help Malaria.com by taking our Malaria Medication Side-effects Survey: Treatment and Prophylaxis. Thank you!

Malaria Cure

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QUESTION

What is the cure for malaria?

ANSWER

Malaria can be cured with a number of different medications, depending on then type of malaria and how far the disease has been progressed.

For standard, non-complicated Plasmodium falciparum malaria, the World Health Organisation recommends use of artemisinin-based combination therapies (ACTs), such as Coartem. This is due to increasing levels of resistance to chloroquine in many parts of the world. Indeed, even though chloroquine is still used in many places as first-line treatment against P. vivax, P. malariae, P. ovale and P. knowlesi uncomplicated malaria, there is some evidence that resistance to this treatment is also emerging, for example in P. vivax in parts of south-east Asia.

In cases where malaria infection has progressed to a stage where oral administration of medication is not possible, or where cerebral symptoms are suspected, the usual treatment option is intravenous quinine.

In addition, P. vivax and P. ovale malaria parasites are able to produce forms (called hypnozoites) which can become dormant in liver hepatocyte cells after the blood stages of the infection have been cleared. These dormant forms can become reactivated weeks or even months or years after the initial infection, which is called a “relapse” of the infection. One drug, called primaquine, is able to kill these liver stages, and so patients with either of these types of malaria should also discuss the possibility of taking primaquine.

Apart from these first-line treatments, there are other medications which are used against malaria, both prophylactically as well as for treatment. These include orally-administered quinine, pyrimethamine, mefloquine, proguanil, atovaquone and sulfonamides.

For more information, see the WHO recommendations for malaria treatment.


What are Gametocytes?

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QUESTION

What are Gametocytes?

ANSWER

Gametocytes are the sexually reproductive form of the malaria parasite. They circulate in the blood of the human/mammal host and are picked up by the mosquito when it takes a blood meal.

Inside the mosquito, the gametocytes undergo sexual reproduction in the mosquito midgut, producing oocysts which attach to the midgut wall and produce sporozoites, which are the stage that are infective to humans when the mosquito takes another blood meal (the sporozoites are passed into the blood via the saliva of the mosquito).

What do people look like when they have malaria?

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QUESTION

What do people look like when they have malaria?

ANSWER

They look sick! When a person has malaria, they experience a flu-like illness, characterised by cycles of fevers and chills, and often accompanied by headaches and nausea. In addition, they may have jaundice (a yellowing of the skin and eyes) due to loss of red blood cells.

Slight Malaria

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QUESTION

Does “slight malaria”  mean you have malaria?

ANSWER

You have malaria if you are infected with the Plasmodium parasites that cause malaria. However, having a few of the parasites does not mean you experience symptoms of the disease.  Some forms of malaria, like P. malariae, can persist in a patient without causing any symptoms. However, in some cases, particularly P. falciparum and also P. knowlesi, a slight initial infection can rapidly increase in a severe, heavy infection, requiring immediate treatment. So it is important to to always consider a diagnosis alongside clinical symptoms as well as an appreciation of the different types of malaria and how they can progress.

ACT Therapy, Missed Doses

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QUESTION

I had recently encountered with malaria and started artemether and lumefantrine . Out of 6 tab of 80mg 4  I had taken 2 missed. Please suggest.

ANSWER

When a dose of ACT is missed, do not take an extra dose to compensate. Instead, take the next dose as soon as you remember, and continue until you have taken all of the tablets. Keep a close watch on any symptoms of illness that might suggest recrudescence (which occurs when all the parasites in the blood have not been killed, and so can begin to multiply again after treatment finishes).

If you suspect recrudescence, go back to your doctor for another diagnosis, and another dose of ACT. Please comply to the treatment and do not miss doses! This can lead to resistance against the drugs developing in the malaria parasites.

Recovery Time

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QUESTION

My friend was diagnosed with P. Falciparum today. She was suffering from high fever, shivering and all the symptoms related to Malaria. She is now hospitalized after 1 week of these symptoms and her medication has started. I know this malaria is dangerous. Can you please tell me how much time it would take to be in the normal state and time to recover? Do reply, I’m waiting for your comments.

ANSWER

It is good to hear that your friend sought out diagnosis and is now being treated. Most people recover within a few days of starting treatment, so she should be feeling better very soon, although it is likely she may feel weak for up to a week or two after completing the treatment.

Malaria Blogs

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QUESTION

Are there any malaria blogs written by field staff or others working in malaria endemic areas? Most of the discussion I see on the web is focused on research and general knowledge, as opposed to day-to-day efforts to distribute bed nets, treat infections, and control the vector in local areas.

I would be interested to read the accounts of individuals working on malaria at the local level.

Thank you.

ANSWER

Thanks for your question! I agree, there is a dearth of accounts from individuals who work on malaria in the field. We are actually trying to get more content of that type here on Malaria.com, so keep checking back!