by Malaria Q&A
QUESTION
Can I take paracetamol (acetaminophen) with Coartem?
ANSWER
Yes – there are no known drug interactions or contra-indications between these two medications. Paracetamol (known as acetaminophen in the USA) is a very effective way of reducing fever so can be used to this end, together with specific anti-malaria medication such as Coartem, during a malaria attack.
by Malaria Q&A
QUESTION
I am holidaying in South Africa in January. 2014 including a visit to Kruger national park. Do I need anti malarial medication?
ANSWER
According to the Centers for Disease Control (CDC), malaria is present in Kruger National Park:
| Country Name | Malaria in Country | Drug Resistance | Malaria Type | Prophylaxis for Areas with Malaria |
|---|---|---|---|---|
| South Africa | Present in the northeastern KwaZulu-Natal Province as far south as the Tugela River, Limpopo (Northern) Province, and Mpumalanga Province.ﾠPresent in Kruger National Park. | Chloroquine | P. falciparum 90%, P. vivax 5%, P. ovale 5% | Atovaquone-proguanil, doxycycline, or mefloquine |
by Malaria Q&A
QUESTION
What are some traditional treatments for malaria?
ANSWER
Many different cultures have had their own traditional ways of treating malaria. Perhaps the two best known come from the native tribes in the Western Amazon basin and the ancient Chinese.
Tribes in the Amazon used the bark of a shrub called Cinchona to treat fevers and shivering; Spanish priests in this region observed traditional Quechua healers using this bark and started using it themselves to treat the fevers associated with malaria. Many centuries later, the active ingredient from this bark was isolated and called quinine, which is still used in the treatment of malaria today.
In ancient China, traditional healers would use the plant sweet wormwood (Artemisia annua, to give it its full Latin name), also to treat fevers and the symptoms of malaria. For many hundreds of years, this traditional cure was forgotten about, until the 1970s when a concerted effort led by Mao Tse-Tung began to search for new anti-malarial compounds as part of their Vietnam war effort. Their scientists, led by Dr Youyou, re-discovered sweet wormwood and extracted a potent anti-malarial compound from it, called artemisinin. This compound and and its many derivatives, in the form of artemisinin-based combination therapies (ACTs), are now the mainstay of the World Health Organization’s first-line recommended treatment against uncomplicated malaria.
by Malaria Q&A
QUESTION
What are the lasting effects of malaria?
ANSWER
Most people who get malaria and receive the correct treatment in time, usually have no long term affects of malaria infection.
However some people who have suffered severe cerebral malaria (from P. falciparum) may experience some longer term neurological effects. There have been reports that up to 25% of young children with severe malaria experience neurological, behavioral or motor problems afterwards.
Other types of malaria, such as P. ovale and P. vivax, can form dormant life stages which hide in the liver for weeks, months or even years, leading to relapse at a later date. However, apart from these recurrences, there are also no long term effects of infection with these types of malaria.
by Malaria Q&A
QUESTION
What is the pathophysiology of malaria?
ANSWER
Malaria causes disease through a number of pathways, which depend to a certain extent on the species. Malaria is caused by a single-celled parasite of the genus Plasmodium; there are five species which infect humans, being Plasmodium falciparum, P. vivax, P. ovale, P. malariae and P. knowlesi.
All these species are introduced into the human blood stream through the bite of an infected mosquito; the life stage of malaria at this point is called a “sporozoite”, and they pass first to the liver, where they undergo an initial stage of replication (called “exo-erythrocytic replication”), before passing back into the blood and invading red blood cells (called “erythrocytes”, hence this is the “erythrocytic” part of the cycle). The malaria parasites that invade red blood cells are known as merozoites, and within the cell they replicate again, bursting out once they have completed a set number of divisions. It is this periodic rupturing of the red blood cells that causes most of the symptoms associated with malaria, as the host’s immune system responds to the waste products produced by the malaria parasites and the debris from the destroyed red blood cells. Different species of malaria rupture the red blood cells at different intervals, which leads to the diagnostic cycles of fever which characterise malaria; P. vivax, for example, tends to produce cycles of fever every two days, whereas P. malaria produces fever every three.
In addition, Plasmodium falciparum produces unique pathological effects, due to its manipulation of the host’s physiology. When it infects red blood cells, it makes them stick to the walls of tiny blood vessels deep within major organs, such as the kidneys, lungs, heart and brain. This is called “sequestration”, and results in reduced blood flow to these organs, causing the severe clinical symptoms associated with this infection, such as cerebral malaria.
More details on the exact biochemical mechanisms for sequestration and its effect on the pathology of the infection can be found on the Tulane University website.
by Malaria Q&A
QUESTION
What are the short term and long term effects of malaria?
ANSWER
In the short term, malaria can cause a variety of symptoms including shaking chills, headache, muscle aches, and tiredness. Nausea, vomiting, and diarrhea. Malaria may also cause anemia and jaundice (yellow coloring of the skin and eyes) because of the loss of red blood cells. Once treated, most people return to normal. However, in severe cases of malaria, especially in children, those that survive may suffer from cognitive, motor , behavior problems and even epilepsy.
by Malaria Q&A
QUESTION
Do you need to take Malaria Tablets in SAL Cape-Verde?
ANSWER
The risk of malaria in Cape Verde is very low. The Centers for Disease Control and Prevention in the US do not recommend taking antimalarials during visits there. In fact, the only part of Cape Verde where a few cases of malaria have been reported is Saõ Tiago Island, so if you visit there, you may just want to be careful and make sure you don’t get bitten by mosquitoes, for example by wearing insect repellent and long-sleeved clothing at night and in the evenings.
by Malaria Q&A
QUESTION
What is the cause of malaria?
ANSWER
Malaria is caused by a parasite called Plasmodium, which is transmitted via the bites of female anopheles mosquitoes. Please read more information on our website: Malaria Symptoms and Causes.
by Malaria Q&A
QUESTION
If a mosquito carrying malaria is biting you, do you get sick the next day?
ANSWER
No. There is a delay called the incubation period, which usually is between 7 to 30 days (depending on the malarial parasite the anopheles mosquito is carrying). The shorter periods are observed most frequently from P. falciparum and the longer ones with P. malariae.
Antimalarial drugs taken for prophylaxis by travelers can delay the appearance of malaria symptoms by weeks or months, long after the traveler has left the malaria-endemic area. (This can happen particularly with P. vivax and P. ovale, both of which can produce dormant liver stage parasites; the liver stages may reactivate and cause disease months after the infective mosquito bite.)
Such long delays between exposure and development of symptoms can result in misdiagnosis or delayed diagnosis because of reduced clinical suspicion by the health-care provider. Returned travelers should always remind their health-care providers of any travel in malaria-risk areas during the past 12 months.
by Malaria Q&A
QUESTION
Does malaria affect your brain?
I was 18months when I had it and I almost died. I didn’t talk until I was 3 years old and have always had troubles with schooling. Now I’m 23 and for at least 3/4 years I’ve had problems with my memory and speech. I don’t know if its new or I have just been noticing it more since I’m older and I’m still experiencing my learning troubles. So can this be a result of my malaria?
ANSWER
In fact, cerebral malaria (one of the most severe and deadly manifestations) is linked to mental and developmental issues later in life. In sub-Saharan Africa, where the vast majority of cases of cerebral malaria in children are found, malaria is actually a leading cause of neuro-disability. As such, it could well be that some of the difficulties you have experienced with memory, speech and learning could have been at least partially caused by infection with malaria as a young child. It may be that certain forms of neuro-therapy may assist in improving some of your difficulties, though you would have to talk to a specialist in neurodisabilities.