by Malaria Q&A
QUESTION
Do we have to go empty stomach for test of malaria?
ANSWER
No – for a malaria test, they will take your blood and either look at it under the microscope or use it in a rapid diagnostic test (RDT) for malaria. Neither of these tests will be affected by whether you eat or not.
by Malaria Q&A
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).
by Malaria Q&A
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).
by Malaria Q&A
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.
by Malaria Q&A
QUESTION
How can I protect myself from being infected with malaria?
ANSWER
There are many ways to prevent from getting infected with malaria. Some methods are more appropriate if you live in a malarial area, others are more for travellers to malarial areas, who are not staying long term. MALARIA.com has a comprehensive page dedicating to malaria prevention and protection.
by Malaria Q&A
QUESTION
What is the dosage for a toddler who is taking Lumartem tablet?
ANSWER
Lumartem, like many anti-malarial drugs, is dosed by weight. Therefore if your toddler weights 5-15kg, s/he should be give one tablet (containing 20mg of artemether and 120mg of lumefantrine) immediately after diagnosis of malaria, then another tablet 8 hours after the first one, then one tablet every 12 hours after that until the end of the 3rd day (a total of 6 tablets, taken over 6 doses).
For children weighing 15-25kg, the timing of the doses is the same, but each time, give two tablets. Try not to miss a dose, but if you do, give the child the missed dose as soon as you remember, then wait the prescribed time interval (12 hours, usually) before giving the next one. Do not give a double dose.
by Malaria Q&A
QUESTION
I just read the CDC recommended medicines for preventing malaria and I am confused. It gives the pros and cons for taking one drug over another. My husband and I are in excellent health, we need our td boosters. Our 15 year old is current in his vaccinations. We will be in D.R. for 2.5 weeks near Jarabacoa then Rio San Juan. We will be on a missionary trip. What medicine should be take in your opinion before hand?
ANSWER
Apart from some basic differences, particularly regarding which forms of malaria they are effective and against, and in what areas of the world, the choice of which anti-malarial to take mostly comes down to personal preferences. So, for example, in most of Africa, malaria is resistant to chloroquine, so this drug is not recommended for travellers; conversely, in parts of Thailand, malaria is resistant to mefloquine, so likewise, if travelling to those areas, you would need to pick another drug.
Having said that, in the Dominican Republic the malaria is sensitive to all forms of anti-malarial drugs, so you don’t have to worry about that. Between the four main types of drug you can take (atovaquone-proguanil, doxycycline, mefloquine and chloroquine), there are significant differences in price, frequency and duration of taking the tablets and side effects, all of which may influence your decision to take one over another. They are all roughly equal in terms of their efficacy in preventing malaria, apart from when resistance is an issue, as I’ve mentioned.
Of the four, chloroquine and mefloquine are taken weekly, while atovaquone-proguanil (often sold as Malarone) and doxycycline are taken daily. Some people prefer the convenience of only having to take a pill every week, but the disadvantage is that these both have to be started 2 weeks before you travel, whereas the daily medications can be started the day before you leave. While Malarone only needs to be taken for one week after returning from your trip, the others should be taken for a full four weeks, to ensure that malaria does not surface once you’re back.
All have some reported side effects, but in my experience, Malarone has the fewest and the most mild, though some people report upset stomachs and disturbed sleep. Chloroquine also has some potential gastrointestinal side effects and can also produce itching, which is a particularly common side effect in people of African descent. The tablets have a metallic taste which some people find unpleasant.
Doxycycline is also an antibiotic, which means it can also help prevent other infections while travelling, though one of its common side effects is sun sensitivity, which may make it less suitable for travelling in tropical areas (personally I have not experienced this side effect, though I have known many people who have).
Mefloquine (sold as Lariam) is not recommended for people with a history of mental illness, and is known to have psychiatric side effects, including nightmares, hallucinations and even altered behavior (again, my whole family took Lariam during one trip, and no one experienced any such side effects, but you should be aware of the possibilities).
Another important factor to consider is price: doxycycline is usually the cheapest drug, and Malarone the most expensive (could be as much as $100 for each of you, for enough to cover the 2.5 week trip, plus a week of tablets once you get back), with the others somewhere in between.
Again, ultimately the choice usually comes down to what factors are important to you and your personal preference. I tend to pay the extra for Malarone since I prefer the convenience of starting the pills right before I leave, and only taking them for a week when I return. Furthermore, when I am away, I am usually working outside, and so would rather not risk the potential sun sensitivity side effect of doxycycline. You should also talk with your doctor about what is usually available in your area from local pharmacies, as they may not carry the full selection of choices.
by Malaria Q&A
QUESTION
How many people have died from malaria since 1966?
ANSWER
Accurate counts of the number of people who die from malaria are notoriously hard to make, since often the infection goes diagnosed, or the cause of death is not reported. However, the World Health Organization has estimated that until recently, about 1 million died each year from malaria. So, without taking into account changes in population size or other demographic factors, that means roughly 45 million people have died from malaria since the mid 1960s.
In the last few years, large-scale coordinated global efforts as well as numerous grass-roots campaigns have sought to reduce the number of deaths from malaria, mainly through improved preventive methods, education, diagnosis and treatment availability. As such, in 2010, it was estimated that deaths were down to about 700,000 per year, though that figure is contested by some, who argue it should be far higher. Organizations such as Malaria No More and the Roll Back Malaria consortium seek to prevent all deaths from malaria by the year 2015, and are working tirelessly to achieve that target.
by Malaria Q&A
QUESTION
My body is getting hotter after taking artesunate and mtivitamen tablet, the pain subsides, but later in the evening my body starts getting hotter, I have taken almost four artesunate, yet the body pain and headache refuse to go, pls sir is it malaria or what.
ANSWER
Unfortunately the symptoms of malaria are quite general, and just having a fever could be a sign of malaria but also of many other diseases. You should go to a doctor or clinic to have a blood test—there, they will take some of your blood and look at it under the microscope to determine whether you have malaria parasites in your blood. If you do, they will give you appropriate treatment—it is actually not recommended to take artesunate by itself, and rather it should be taken together with a secondary anti-malarial drug, in a combination known as an artemisinin-based combination therapy (ACT).
Common forms of ACTs available in Africa include artemether-lumefantrine (sold as Alu, Lonart or Coartem) and dihydroartemisinin-piperaquine (sold as Artekin or Duo-Cotecxin). Artesunate comes in combination with amodiaquine, and is often abbreviated as ASAQ.
If you do not get properly diagnosed in a medical facility, you risk treating yourself with unnecessary drugs if in fact you actually have another infection, or you might find you are giving yourself the wrong type of treatment for your malaria infection.
by Malaria Q&A
QUESTION
where did malaria come from?
ANSWER
Malaria is a disease caused by a single-celled parasite called Plasmodium. There are many species of Plasmodium, which infect many other animals as well as humans. The types of malaria which infect humans probably evolved from similar Plasmodium species in monkeys and apes; for example, P. vivax is closely related to several species of malaria that infect macaque monkeys in south-east Asia, while P. falciparum, the most severe and deadly kind of malaria, probably evolved from similar infections in chimpanzees and gorillas in central Africa. This transition from other primates to humans occurred many thousands of years ago; further back in time, the types of Plasmodium which infect mammals (rodents can also be infected with Plasmodium) are thought to have jumped over from Plasmodium species which infect birds and reptiles. Even before that, Plasmodium itself seems to have evolved from other types of blood-borne parasites which infect birds and reptiles.