Areas Where Malaria Occurs

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QUESTION

Can you please tell me the high, low and no risk areas for malaria.

ANSWER

Malaria requires certain climatic conditions, both for its own development as well as for the survival of its vector mosquitoes. As such, malaria transmission is concentrated in lowland areas of the tropics, where there is sufficient freshwater for mosquito breeding. However, malaria can also seasonably be transmitted in areas away from the tropics. Similarly, some tropical and sub-tropical areas have implemented successful control programs which has significantly reduced or even eliminated transmission.

Currently, high risk areas for malaria transmission include most of sub-Saharan Africa (except for the highlands of Ethiopia, Tanzania, Kenya and Eritrea – areas over 1800 meters of altitude tend to have less malaria), most of northern South America (except areas over 2000m, and many urban cities are also free of malaria), parts of Central America, some Caribbean islands, India, south-east Asia (again, apart from highland areas) and Oceania. Low risk areas include parts of southern Africa (i.e. northern South Africa), parts of Central America (including most of Mexico, though some parts of the south may be considered higher risk), parts of the Middle East and parts of China. There is no known malaria in North America, Europe, most of North Africa, Australia, New Zealand, Japan, the eastern coastal regions of Brazil, most of southern South America and northern Asia. For a detailed and up to date map of malaria risk around the world, please see the Malaria Map

Malaria and Stomach Ache

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QUESTION

Can a person suffering from malaria suffer from stomach-aches?

ANSWER

Sometimes people with malaria have nausea,  vomiting and diarrhea, but the most common symptoms include fever and flu-like illness, such as shaking chills, headache, muscle aches, and tiredness. Malaria may cause anemia and jaundice (yellow coloring of the skin and eyes) because of the loss of red blood cells.

 

Malaria and Menstrual Cycle

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QUESTION

Does malaria affect menstrual cycle?

ANSWER

Malaria usually does not last very long—people usually seek diagnosis and treatment within a few days (since symptoms can be severe) and then treatment and recovery follow swiftly, within another few days (100% recovery may take longer, up to a few weeks). Moreover, malaria does not usually interfere with reproductive organs or hormone production. As such, malaria usually does not interfere with the menstrual cycle. However, malaria can result in anemia; many women also experience mild anemia during and after menstruation, and it is possible that this iron deficiency could be exacerbated by malaria infection.

Malaria Medication During Breast Feeding

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QUESTION

I am a breast-feeding mother, and I am on the lumartem dosage. Will this affect my baby? He is 9 months old.

ANSWER

The US Center for Disease Control says that it is safe for a breastfeeding mother to take lumfartem if the baby is over 5 kilos (or 11 pounds).    Since your baby is 9 months old, he should weigh more than 5 kg so you should be fine. If you have any questions you should talk to the health care provider who gave you the medication.  Make sure you and the baby sleep under a long acting insecticide treated net to prevent further episodes of malaria.

Malareich and Pregnancy

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QUESTION

Hi , am 31 weeks pregnant and had to take Malareich as my Anti malaria drug. I did not take the drug until I felt I had malaria, because I had body pains and headaches. Please advise if I will be ok after taking the malareich.

ANSWER

Malareich is a combination drug comprising of sulfadoxine and pyrimethamine, which is one of the medications recommended for treatment of malaria in pregnant women. However it sounds like you took the medication because you thought you had malaria – it is really important to be diagnosed by a doctor. For example, they will be able to ensure that you get the correct type of treatment for the kind of malaria you have. Malareich, for example, is probably not as effective against P. vivax malaria as P. falciparum malaria, but P. vivax is still susceptible to chloroquine, which is another drug that is suitable for the treatment of malaria in pregnant women.

Malaria Transmission by Contact?

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QUESTION

If you come in contact with someone who has had malaria can you get it from them?

ANSWER

No. It is not transmissible directly between people. Most transmission of malaria occurs when a mosquito infected with the malaria parasites bites someone, who then may get malaria. In some cases, transfers of organs or large quantities of infected blood (such as during blood transfusion) may also result in transmission, though this is more rare, and screening of blood reduces the probability of it occurring. Malaria can also be transmitted from a mother if she has malaria to her unborn child via the placenta, or via blood during childbirth. This is called congenital malaria.

Mosquito Larvae Eradication

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QUESTION

What measures can be taken to eradicate the mosquito larvae?

ANSWER

The usual, traditional method of eradicating mosquito larvae is through the application of insecticides. However many of these are known to have severe negative effects on water quality, particularly through being non-selectively toxic and therefore killing lots of other aquatic life as well as the mosquitoes. Moreover, some are known for their effects on animals further up the foodchain; the most famous example of this being DDT, which was used to kill adult mosquitoes. It was discovered that this pesticide resulted in birds laying eggs that had very thin shells, preventing the chicks from hatching successfully. As such, it was banned in most developed countries. Modern insecticides used for mosquito larva reduction have been developed to target mosquitoes specifically; a popular one in the USA is methoprene, which interferes with the mosquitoes’ growth hormones, preventing development into adults. Microbial compounds, which are not dangerous to other organisms, are also sometimes used.

Another approach is through the use of natural enemies of the mosquito larvae, notably certain species of fish and dragonflies. These will eat mosquito larvae and pupae, thus naturally reducing numbers, and with little undue effect on water quality (although in some contexts, such as reservoir water, there may be concerns with stocking the water source with large numbers of fish).

What are the complications from malaria?

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QUESTION

What are the complications of malaria?

ANSWER

Malaria in humans can be caused by a number of different parasites – the most dangerous, and the one which is responsible for over 90% of the worldwide deaths from malaria, is Plasmodium falciparum. Complications can include impaired consciousness, coma and even death. When a pregnant women gets malaria, there is danger of a miscarriage, giving birth to a low birth weight baby, and passing the infection to the baby.

If diagnosed and treated promptly, most cases of P. falciparum can be resolved quickly and without complications, using oral medication. However, the parasite can reproduce very quickly, meaning that cases can become more serious within days and even hours. As such, if P. falciparum infection is suspected, and particularly in high-risk individuals such as young children, pregnant women and immunocompromised individuals, diagnosis should be sought immediately so that appropriate treatment can be delivered.

There is a discussion going on about the question of possible long-term consequences of malaria infection based on an earlier question in this forum. You can follow the discussion here: Long Term Health Effects of Malaria When Young.

In summary, there is little evidence of any long term effects on health from having single or relatively few malaria infections; however, this may partly be through lack of concerted research on this topic. Most research looks at the impact of chronic or very frequent malaria infections, such as that experienced by young children living in holo-endemic areas (i.e. sub-Saharan Africa).

At what age can you get malaria?

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QUESTION

What age do you get malaria?

ANSWER

Malaria is transmitted by the bite of an infected mosquito, and therefore any one living  where malaria is present, at any age,  is susceptible. To prevent malaria,  sleep under a long-lasting insecticide treated bednet; make sure it is re-dipped in insecticide every year or so to maintain its efficacy. The mosquitoes which transmit malaria tend to feed at night, and so protecting yourself and your home during the evening, night and early morning is crucial. Maintaining good screens on all windows and doors can be a very effective way of preventing mosquitoes from entering, and in many parts of the world, people spray inside with insecticides to reduce the number of mosquitoes yet further. Wearing long-sleeved clothing at night and in the evenings can also prevent bites.

Pregnant women though, due to changes to the mother’s immune system and also perhaps due to the physiology of the placenta, are very vulnerable to malaria. There is also the risk (up to 33% in some studies) that malaria will pass directly from the mother to the baby, either through the placenta or in blood during childbirth—this is called “congenital malaria,” and can manifest as early as 1 day after delivery but a late as months after. The symptoms are similar to that of adult malaria, with fever, anaemia, lethargy, etc.

Even if the unborn baby does not get congenital malaria, it can be effected by its mother having malaria during pregnancy, with possible low birth weight, anaemia and even spontaneous abortion—abortion rates due to malaria can vary between 15-70%.

Given these negative effects, it is very important to protect pregnant women against malaria, and bednet distribution schemes in many places target these women. In high transmission settings, women may also be offered intermittent preventive therapy (IPT) which consists of at least two doses of anti-malarial medication, usually once during the second and once during the third trimester.