Medicines to Prevent Malaria?

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QUESTION

Which medicines are used to prevent malaria?

ANSWER

There are a number of drugs used to prevent malaria infection, known as malaria prophylactic medication. These vary in terms of how they are taken, how long they are taken for, how much they cost and the typical side effects people experience while they are taking them. In addition, some are recommended more highly for certain types of malaria or certain regions of the world, due primarily to the emergence of resistance in certain areas.

The most common forms of malaria prophylaxis used are doxycycline, atovaquone/proguanil (sold under the brand name Malarone), chloroquine (sold as Aralen) and mefloquine (sold as Lariam). More information on these, on other types of prophylaxis and malaria prevention in general can be found on our Malaria Prevention page.

How is Malaria Cured?

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QUESTION

How is malaria cured?

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.

Do Sporozoites in blood signal the end of prepatent period?

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QUESTION

Will the appearance of sporozoites in blood mark the end of prepatent period in malaria?

ANSWER

Actually, no. The presence of sporozoites indicates the start of the infection. Sporozoites are introduced into the bloodstream via the bite of an infected mosquit0. The sporozoites then have to make their way to the liver and infect hepatocyte cells, where they undergo pre-erythrocytic schizogony. This is where the malaria parasites produce multiple copies of their nucleus without dividing the cytoplasm of the cell; new copies of the cell are produced by budding. These new cells are called merozoites, and they are released back into the blood, where they search for erythrocytes (red blood cells) to infect.

This is the end of the pre-patent period in malaria, as the symptoms of disease will start once the merozoites infect and rupture the host’s red blood cells, and parasitaemia may also be detected at this stage through observation of peripheral blood samples.

Dietary Values in West Africa

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QUESTION

In many West African countries where malaria attacks the general population of the people what is their dietary intake like? What are their foods or nutritional values?

ANSWER

In most West African countries, the diet is dominated by starchy tubers or grains, such as cassava, rice, sorghum and millet. This base foodstuff is often served alongside a vegetable or meat-based stew or soup, often thickened with leafy greens or vegetables such as okra. Meat has gained in popularity in recent years, and there has also been a shift from the use of traditional oils (palm oil near the coast and shea nut oil further inland) to processed and hydrogenated vegetable oils.

While the traditional diet is fairly balanced, the emphasis on high amounts of starch can lead to mild malnourishment (particularly through lack of protein) and micronutrient deficiencies. Increasing the proportion of meats and oils in the diet, as is becoming more common, tends to reverse malnutrition into obesity, while not solving the micronutrient deficiencies.

Having said all that, there is little evidence that diet can specifically protect against malaria infection, although good overall health, which can be assisted by a healthy, balanced diet, may provide some protection against progression of the disease and the ability to fight the infection.

How did it get the name “malaria”?

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QUESTION

How did malaria get its name?

ANSWER

The word “malaria” comes from Italian, “mala aria” which literally translates to “bad air”. This came from the ancient association, traced back as far as the ancient Greeks and Romans, that the disease was associated with swampy, marshy areas where the air smelled bad.

The mechanism of transmission was not known back then, nor did they know anything about infectious disease agents like bacteria, viruses or the single-celled protozoa like what causes malaria. So they believed it was the air itself that caused the infection, hence giving malaria its name. The protozoan which causes malaria was not discovered until 1880 when Charles Louis Alphonse Laveran observed the parasites in a patient; it was a few years later, in 1897/1898, that Ronald Ross discovered that mosquitoes transmitted malaria between human hosts. He won a Nobel Prize for this discovery in 1902.

What is Malaria?

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QUESTION

What is malaria?

ANSWER

Malaria is a disease caused by parasites of the genus Plasmodium. Transmitted by mosquitoes, there are several different kinds of malaria distributed throughout the tropical and sub-tropical regions of the world, causing somewhere between 300-500 million cases of disease each year, and as many as 1 million deaths. In fact, malaria is one of the biggest killers of children under the age of five in sub-Saharan Africa, one of the regions of the world where the burden from malaria is the highest. Malaria is usually an acute disease, manifesting itself with severe fever, chills, headache and often nausea as well. Some types of malaria can have relapsing episodes over a time period of many years.

Having said this, malaria is easily preventable, through avoiding mosquito bites by wearing appropriate clothing and sleeping under insecticide-treated bednets, or through taking preventative medication (called prophylaxis). Malaria is also treatable once symptoms appear, through ingesting safe, effective and relatively cheap drugs. With such control measures at hand, you may ask why malaria is still such a huge problem in our world; the answer is that delivering control strategies and treatment to populations most at risk is difficult, and often countries with high malaria burdens don’t have efficient and effective health systems in place to coordinate control efforts.

International non-governmental organisations such as the World Health Organisation, as well as a multitude of non-profit organisations such as the Malaria Consortium and Malaria No More, work tirelessly to bring malaria control and treatment to the places that need it most, with the aim to eradicate malaria as a disease of public health importance.

Who introduced malaria in which century?

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QUESTION

Who introduced malaria in which century, how does it cause malaria and what is the virus’ name?

ANSWER

Malaria wasn’t introduced; it has been evolving alongside humans for thousands, if not millions of years. The first known mention of malaria by humans is in an ancient Chinese medical text, from 2700 BCE (before common era). Other ancient people, such as the Romans and the Greeks, knew the symptoms of malaria and described it in writing.

Malaria is actually not caused by a virus, but a single-celled animal called a protozoan. The genus name of the protozoans that cause malaria is Plasmodium, and there are five main species that infect humans: P. falciparum, P. vivax, P. ovale, P. malariae and P. knowlesi.

The malaria parasites cause the disease by entering into red blood cells and multiplying; when they have reproduced, they burst out of the red blood cell, destroying it. The patient’s blood is therefore rapidly full of malaria parasites, their waste products, plus bits of destroyed red blood cell; this produces an extreme immune reaction which causes many of the symptoms of malaria. In infection with P. falciparum, the most deadly and severe kind, infection with the parasite causes red blood cells to sequester in tiny red blood cells within major organs, causing reduced oxygen flow and complications. When this occurs in the brain, the result is cerebral malaria, which can result in convulsions and even a coma.

Signs of Malaria

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Hello my question is how do I see malaria signs if i haven’t gone to check yet?

 

The key is to recognise whether you have any potential symptoms of malaria, or if you have been bitten a lot by mosquitoes recently and live in an area where malaria is present. Malaria can have many different symptoms, but the initial signs are similar to a flu-like illness, with high fever, chills, headache and muscle soreness or aches. A characteristic sign of malaria is cyclical fever, with peaks of severity every two or three days. Additionally, some people will experience nausea, coughing, vomiting and/or diarrhea.

Because these symptoms are quite generic of a wide variety of illnesses, if you live in a malaria-endemic region, it is crucial to be tested when you develop such symptoms. If you have recently traveled to a malarial area and start to experience these signs of infection, similarly you should inform your doctor of your travel history, as otherwise they might not recognize your symptoms as potentially that of malaria.

If you live in a malarial area, you can always visit a clinic and see if they will do a test to screen you for malaria, even if you don’t have the above symptoms. People who live in malarial areas develop partial immunity to the disease, meaning that new infections do not always present themselves as acutely as when they were children, or in people who are being infected for the first time. As such, some people can have low levels of parasite in their blood and while they may feel tired or a bit under the weather, do not have specific symptoms. This is especially the case for the less severe and deadly forms of malaria, such as Plasmodium vivax, P. ovale and P. malariae, so if you live in an area where any of these three are present, it might be worth getting a malaria test even if you don’t have symptoms.

However, it is very important not to accept treatment unless you are confirmed as having a positive diagnosis for malaria; taking treatment without having the disease can lead to resistance to the medication, and you may also experience side effects, which, though usually mild, are still probably better to avoid!

What is Malaria?

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QUESTION

What is it?

ANSWER

I have copied the below answer from an earlier question also asking what malaria is:

Malaria is a disease caused by parasites of the genus Plasmodium. Transmitted by mosquitoes, there are several different kinds of malaria distributed throughout the tropical and sub-tropical regions of the world, causing somewhere between 300-500 million cases of disease each year, and as many as 1 million deaths. In fact, malaria is one of the biggest killers of children under the age of five in sub-Saharan Africa, one of the regions of the world where the burden from malaria is the highest. Malaria is usually an acute disease, manifesting itself with severe fever, chills, headache and often nausea as well. Some types of malaria can have relapsing episodes over a time period of many years.

Having said this, malaria is easily preventable, through avoiding mosquito bites by wearing appropriate clothing and sleeping under insecticide-treated bednets, or through taking preventative medication (called prophylaxis). Malaria is also treatable once symptoms appear, through ingesting safe, effective and relatively cheap drugs. With such control measures at hand, you may ask why malaria is still such a huge problem in our world; the answer is that delivering control strategies and treatment to populations most at risk is difficult, and often countries with high malaria burdens don’t have efficient and effective health systems in place to coordinate control efforts.

International non-governmental organisations such as the World Health Organisation, as well as a multitude of non-profit organisations such as the Malaria Consortium and Malaria No More, work tirelessly to bring malaria control and treatment to the places that need it most, with the aim to eradicate malaria as a disease of public health importance.

How does oxygenated blood reach the brain?

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QUESTION

How does the oxygenated blood actually reach the brain???

ANSWER

Two main artery pairs supply the brain with oxygenated blood from the lungs. These are the internal carotid arteries and the vertebral arteries.

One of the major risks of infection with Plasmodium falciparum malaria is that the parasite induces red blood cells to sequester to the sides of small blood vessels in major organs, rather than stay in the peripheral blood system in the limbs. If this happens in the brain, the resultant loss of oxygen supply and other complications leads to cerebral malaria, which is a serious condition and can lead to convulsions, permanent neurological damage and even coma and death. As such, it is crucial to treat all cases of malaria swiftly and effectively, but none so urgently as P. falciparum infections.